Tawfik Eman A, Cartwright Michael S, van Alfen Nens, Axer Hubertus, Boon Andrea J, Crump Nicholas, Grimm Alexander, Hobson-Webb Lisa D, Kerasnoudis Antonios, Mandeville Ross, Preston David C, Sakamuri Sarada, Shahrizaila Nortina, Shin Susan, Shook Steven J, Wilder-Smith Einar, Walker Francis O
Department of Physical Medicine & Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Muscle Nerve. 2023 Oct;68(4):375-379. doi: 10.1002/mus.27830. Epub 2023 Apr 19.
Neuromuscular ultrasound has become an integral part of the diagnostic workup of neuromuscular disorders at many centers. Despite its growing utility, uniform standard scanning techniques do not currently exist. Scanning approaches for similar diseases vary in the literature creating heterogeneity in the studies as reported in several meta-analysis. Moreover, neuromuscular ultrasound experts including the group in this study have different views with regards to technical aspects, scanning protocols, and the parameters that should be assessed. Establishing standardized neuromuscular scanning protocols is essential for the development of the subspeciality to ensure uniform clinical and research practices. Therefore, we aimed to recommend consensus-based standardized scanning techniques and protocols for common neuromuscular disorders using the Delphi approach. A panel of 17 experts participated in the study, which consisted of three consecutive electronic surveys. The first survey included voting on six scanning protocols addressing the general scanning technique and five common categories of suspected neuromuscular disorders. The subsequent surveys focused on refining the protocols and voting on new steps, rephrased statements, or areas of non-agreement. A high degree of consensus was achieved on the general neuromuscular ultrasound scanning technique and the scanning protocols for focal mononeuropathies, brachial plexopathies, polyneuropathies, amyotophic lateral sclerosis, and muscle diseases. In this study, a group of neuromuscular ultrasound experts developed six consensus-based neuromuscular ultrasound scanning protocols that may serve as references for clinicians and researchers. The standardized protocols could also aid in achieving high-quality uniform neuromuscular ultrasound practices.
神经肌肉超声已成为许多中心诊断神经肌肉疾病不可或缺的一部分。尽管其应用越来越广泛，但目前尚不存在统一的标准扫描技术。文献中针对相似疾病的扫描方法各不相同，导致如几项荟萃分析所报道的研究存在异质性。此外，包括本研究团队在内的神经肌肉超声专家在技术方面、扫描方案以及应评估的参数等方面存在不同观点。建立标准化的神经肌肉扫描方案对于该亚专业的发展至关重要，以确保临床和研究实践的一致性。因此，我们旨在采用德尔菲法，为常见神经肌肉疾病推荐基于共识的标准化扫描技术和方案。一个由17名专家组成的小组参与了该研究，研究包括连续三轮电子调查。第一次调查包括对六种扫描方案进行投票，这些方案涉及一般扫描技术以及五类常见的疑似神经肌肉疾病。随后的调查重点是完善方案，并就新步骤、重新表述的陈述或存在分歧的领域进行投票。在一般神经肌肉超声扫描技术以及局灶性单神经病、臂丛神经病、多发性神经病、肌萎缩侧索硬化症和肌肉疾病的扫描方案方面达成了高度共识。在本研究中，一组神经肌肉超声专家制定了六种基于共识的神经肌肉超声扫描方案，可为临床医生和研究人员提供参考。这些标准化方案也有助于实现高质量的统一神经肌肉超声实践。
