Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tuebingen, Germany.
Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tuebingen, Germany.
Clin Neurophysiol. 2022 Sep;141:34-41. doi: 10.1016/j.clinph.2022.06.013. Epub 2022 Jul 4.
Ultrasound can detect enlargement of cervical nerve roots, which has been described in polyneuropathies (PNP), mainly of demyelinating pathology. This study investigates whether neuroforaminal stenosis, as a common but often asymptomatic degenerative change, is associated with nerve root enlargement on ultrasound and whether neuroforaminal stenosis thus confounds cervical nerve root ultrasound findings in the diagnostic assessment of PNP.
We retrospectively studied 182 patients (62 demyelinating, 71 axonal PNP; 49 without evidence of PNP) who had undergone ultrasound of the cervical nerve roots C5 and C6 and magnetic resonance or computed tomography of the cervical spine that was reviewed with respect to neuroforaminal stenoses.
Patients with demyelinating PNP had larger nerve roots than those with axonal/without PNP. No significant differences in cervical nerve root diameters were found between groups with vs. without neuroforaminal stenosis. The diagnostic performance of the discrimination of PNP subtypes based on ultrasound nerve root measurements did not differ significantly when including or excluding subjects with neuroforaminal stenoses.
Neuroforaminal stenosis per se does not entail relevant cervical nerve root enlargement detectable by nerve ultrasound.
Ultrasound assessment of cervical nerve root size in the diagnostic evaluation of PNP is unlikely to be confounded by common degenerative changes of the cervical spine.
超声可检测到颈神经根增粗，这在多发性神经病（PNP）中已有描述，主要为脱髓鞘病变。本研究旨在探讨神经孔狭窄（一种常见但通常无症状的退行性改变）是否与超声检查中的神经根增粗有关，以及神经孔狭窄是否会影响 PNP 诊断评估中对颈神经根超声检查结果的解释。
我们回顾性研究了 182 例患者（62 例脱髓鞘性 PNP、71 例轴索性 PNP；49 例无 PNP 证据），这些患者均接受了 C5 和 C6 颈神经根超声检查以及颈段磁共振或计算机断层扫描检查，并对神经孔狭窄进行了评估。
脱髓鞘性 PNP 患者的神经根比轴索性/无 PNP 患者的神经根更大。有神经孔狭窄和无神经孔狭窄的患者之间，颈神经根直径无显著差异。基于超声神经根测量值对 PNP 亚型进行鉴别诊断的效能，在纳入或排除有神经孔狭窄的患者时，差异无统计学意义。
神经孔狭窄本身并不会导致可通过神经超声检测到的相关颈神经根增粗。
在 PNP 的诊断评估中，超声评估颈神经根大小不太可能受到颈椎常见退行性改变的影响。
