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周围神经(损伤)的组织病理学和高分辨率超声成像。

Histopathology and high-resolution ultrasound imaging for peripheral nerve (injuries).

机构信息

Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.

Pathology Unit, Maggiore Hospital, Bologna, Italy.

出版信息

J Neurol. 2022 Jul;269(7):3663-3675. doi: 10.1007/s00415-022-10988-1. Epub 2022 Jan 29.

Abstract

BACKGROUND

Neuropathies are commonplace in clinical practice and ultrasound assessment of the peripheral nerves is increasingly becoming a valuable diagnostic tool to support the physical and electrophysiological examinations. In the pertinent literature, several sonographic approaches have been proposed to evaluate the peripheral nerve tissue-mainly based on (semi)-quantitative measures.

OBJECTIVE

To define a standardized sonographic approach aiming to evaluate the different sono-histological sections of the peripheral nerve also in a qualitative way.

METHODS

Using high-frequency ultrasound probes and high-level ultrasound machines, we matched the histopathological features of the peripheral nerve (in acute and chronic phase) and the different sonographic patterns. Moreover, high-sensitive power Doppler assessments have been performed to assess the microcirculation of the peripheral nerve in physiological and pathological conditions.

RESULTS

Modern ultrasound equipment allows a "real-time dissection" of the peripheral nerve evaluating the sonographic patterns of its different histological compartments in physiological and pathological conditions. Moreover, high-sensitive power Doppler allows clear visualization of the microcirculation of the peripheral nerve both in the acute and chronic phases of the neuropathy.

CONCLUSION

In clinical practice, using adequate technological equipment, (semi)-quantitative measurements of the peripheral nerve can be coupled with different sonographic patterns of its histological components-both in the acute and chronic phase of the peripheral neuropathy. This way, better/prompt diagnosis and optimal management of the patients would be possible.

摘要

背景

神经病在临床实践中很常见,对外周神经的超声评估越来越成为支持物理和电生理检查的有价值的诊断工具。在相关文献中,已经提出了几种超声评估方法来评估外周神经组织,主要基于(半)定量测量。

目的

定义一种标准化的超声评估方法,旨在以定性方式评估外周神经的不同超声组织学节段。

方法

使用高频超声探头和高级超声设备,我们将外周神经(急性和慢性期)的组织病理学特征与不同的超声模式相匹配。此外,还进行了高敏感功率多普勒评估,以评估生理和病理条件下外周神经的微循环。

结果

现代超声设备允许对外周神经进行“实时解剖”,评估其在生理和病理条件下不同组织学隔室的超声模式。此外,高敏感功率多普勒可清晰显示外周神经在神经病的急性和慢性期的微循环。

结论

在临床实践中,使用适当的技术设备,可以将外周神经的(半)定量测量与神经病变的急性和慢性期的其组织学成分的不同超声模式相结合。这样,可以更准确/及时地诊断并为患者提供最佳的管理。

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