Departments of Neurology and Neurophysiology, Bay Of Plenty District Health Board, Tauranga Hospital, Tauranga, New Zealand.
Department of Neurology, Semmelweis University, Budapest, Hungary.
Clin Neurophysiol. 2021 Sep;132(9):2274-2281. doi: 10.1016/j.clinph.2021.04.018. Epub 2021 May 29.
The addition of ultrasound (US) to electrodiagnostic (EDX) tests can significantly enhance the accuracy of testing for ulnar neuropathy at the elbow (UNE). We aimed to obtain expert consensus to guide clinicians on the combined use of EDX and US in UNE investigation. Consensus was achieved using the Delphi method. Two consecutive anonymised questionnaires were submitted to 15 experts, who were asked to choose their level of agreement with each statement. Consensus was pre-defined as ≥ 80% rating agreement. The experts concluded that all investigations of UNE should include both nerve conduction studies and US. There was consensus that US should include cross-sectional area measurement and assessment of nerve mobility at the elbow, and that the entire ulnar nerve should be imaged. This study defined expert opinion on the 'core' techniques that should be used routinely in the UNE investigation using EDX and US. Areas with lack of consensus highlighted some controversial issues in the current use of these diagnostic modalities and the need for future research. This document is an initial step to guide clinicians on the combined investigation of UNE using EDX and US, to be regularly updated as new research emerges.
超声（US）检查与电诊断（EDX）测试联合应用可显著提高肘管尺神经病变（UNE）检测的准确性。我们旨在获得专家共识，以指导临床医生在UNE 研究中联合使用 EDX 和 US。采用德尔菲法达成共识。连续向 15 名专家发送了两份匿名问卷，要求他们对每个陈述的同意程度进行选择。共识定义为≥80%的评分同意率。专家们得出结论，UNE 的所有检查均应包括神经传导研究和 US。专家一致认为 US 应包括横截面积测量和肘部神经活动性评估，并且应对整个尺神经进行成像。本研究使用 EDX 和 US 定义了在 UNE 检查中应常规使用的“核心”技术的专家意见。共识缺乏的领域突出了这些诊断方式当前应用中的一些争议问题，需要进一步研究。本文件是指导临床医生使用 EDX 和 US 联合检查 UNE 的初步步骤，将根据新的研究进展定期更新。
