Department of Anatomy, Medical School, University of Crete, Heraklion, Crete Greece; Diagnostic and Interventional Ultrasound Practice, Heraklion, Crete, Greece.
Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University Innsbruck (MUI), Innsbruck, Austria.
Ann Anat. 2023 Oct;250:152137. doi: 10.1016/j.aanat.2023.152137. Epub 2023 Jul 26.
INTRODUCTION: High resolution ultrasound (US) of the cervical vagus nerve (CVN) is clinically relevant in the diagnostic workup and during neurostimulation therapy of several neurologic diseases. This prospective study aims to provide reference data of the cross-sectional area (CSA) and fascicle count of the normal CVN and to investigate their possible association with anthropometric data in a large cohort of patients. METHODS: A total of 657 CVNs in 330 individuals without history of neurological disease were examined using US (7-15Mhz). The CVN fascicle count and CSA inside the hyperechoic epineurium at the level of the thyroid lobes were measured. Three CSA measurements were performed to calculate the mean value. Anthropometric data were recorded. RESULTS: The mean fascicle count was 2.4 ± 1.1 (right) and 2 ± 1 (left) (paired t- test, p < 0.001). Two CVN patterns were identified: A single hypoechoic fascicular structure (26.2 % right, 36.3 % left) and a honeycomb structure of 2-6 discrete fascicles (72.3 % right, 63.7 % left). Right CVN mean CSA was larger compared to left (2.3 ± 1 mm and 1.8 ± 0.8 mm respectively, t-test, p-0.000). There was no difference in the CSA values between sex and no correlation to age or height. A positive correlation between the CSA and weight and BMI was found (Pearson's correlation, p = 0.01 right and p = 0.05 left). CONCLUSION: The right CVN has larger CSA and contains more fascicles than the left. CVN is usually mono- or oligo-fascicular with a honeycomb appearance. The CSA increased with increasing BMI but no age and sex specific differences were noted.
介绍:高分辨率超声(US)检查颈迷走神经(CVN)在多种神经系统疾病的诊断和神经刺激治疗中具有重要的临床意义。本前瞻性研究旨在为正常 CVN 的横截面积(CSA)和束数提供参考数据,并在一个大型患者队列中研究它们与人体测量数据的可能关联。
方法:使用超声(7-15MHz)检查了 330 名无神经系统疾病病史的个体的 657 条 CVN。测量了甲状腺叶水平的神经外膜内 CVN 束数和 CSA。进行了 3 次 CSA 测量以计算平均值。记录了人体测量数据。
结果:右侧 CVN 的平均束数为 2.4±1.1(右)和 2±1(左)(配对 t 检验,p<0.001)。两种 CVN 模式:单一低回声束状结构(右侧 26.2%,左侧 36.3%)和 2-6 个离散束的蜂窝状结构(右侧 72.3%,左侧 63.7%)。右侧 CVN 的平均 CSA 大于左侧(分别为 2.3±1mm 和 1.8±0.8mm,t 检验,p<0.000)。CSA 值在性别之间没有差异,与年龄或身高也没有相关性。发现 CSA 与体重和 BMI 呈正相关(Pearson 相关,p=0.01 右侧和 p=0.05 左侧)。
结论:右侧 CVN 的 CSA 大于左侧,包含的束数也多于左侧。CVN 通常为单或寡束状,呈蜂窝状外观。CSA 随 BMI 的增加而增加,但未发现年龄和性别特异性差异。
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