Jorgensen Shawn P, Cartwright Michael S, Norbury John
From the Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, New York (SPJ); Department of Family Medicine, Larner Medical College at the University of Vermont, Burlington, Vermont (SPJ); Adirondack Rehabilitation Medicine, PLLC, Queensbury, New York (SPJ); Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (MSC); and Division of Physical Medicine and Rehabilitation, Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, Texas (JN).
Am J Phys Med Rehabil. 2022 Jan 1;101(1):78-88. doi: 10.1097/PHM.0000000000001790.
Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.
准确评估神经肌肉疾病对于及时治疗并取得最佳疗效至关重要。从历史上看，电诊断研究一直发挥着这一作用，但最近，神经肌肉超声正在电诊断实验室中得到应用。本综述讨论了神经肌肉超声在电诊断实验室中有充分证据支持的用途，重点强调了那些在具备合理设备水平和培训的典型电诊断实验室中可以采用的用途。目前的证据支持使用神经肌肉超声来诊断腕管综合征和肘部尺神经病变，并在怀疑电诊断研究结果为假阴性或存在轴索性非定位性病变时作为补充检查。神经肌肉超声可以识别局灶性单神经病的病因，这在特定情况下可以改变治疗方案。它在识别肌束震颤以及提供自身免疫性脱髓鞘性多发性神经病的补充证据方面很敏感。它在评估创伤后的神经方面特别有帮助。随着技术不断进步，神经肌肉超声在电诊断实验室中可能会被证明更有用。
