Senarai Thanyaporn, Suwannakhan Athikhun, Pratipanawatr Thongchai, Yammine Kaissar, Yurasakpong Laphatrada, Sathapornsermsuk Tanapat, Janta Sirorat, Kittiboonya Achiraya
Microscopy Unit, Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Department of Anatomy, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
J Clin Med. 2023 Sep 25;12(19):6186. doi: 10.3390/jcm12196186.
High-resolution ultrasound of the tibial nerve has been used for screening of several neurologic disorders, but normative reference values of tibial nerve cross-sectional areas (CSA) have not been well established. Thus, the present meta-analysis was performed to generate normative estimates of tibial nerve CSA at various sites of the lower limb based on ultrasonography.
Google Scholar, Scopus and PubMed were searched for potential studies. Studies were required to report tibial nerve CSA in healthy individuals to be included. A random-effect meta-analysis was performed to calculate tibial nerve CSA values. Subgroup and statistical analyses were performed to study covariates.
Forty-eight eligible articles consisting of 2695 limbs were included. The average tibial nerve CSA was found to be 10.9 mm at the ankle (95% CI: 9.9-11.8) and should not exceed 11.8 mm in healthy adults. At the popliteal fossa, the overall CSA was 21.7 mm (95% CI: 17.5-25.8) in healthy adults. At both sites, the average tibial nerve CSA was significantly larger in adults than in children, and the differences by geographical region were not statistically significant. At the ankle, tibial nerve CSA increased with age and body mass index, while at the popliteal fossa it increased with age and weight.
our findings indicate that the tibial nerve varied not only along its course but also among sub-variables. Establishing normal references values of tibial nerve CSA is helpful to differentiate healthy from diseased tibial nerves such as in diabetic peripheral neuropathy or tarsal tunnel syndrome.
高分辨率超声已用于多种神经系统疾病的筛查，但胫神经横截面积（CSA）的正常参考值尚未完全确立。因此，本荟萃分析旨在基于超声检查得出下肢不同部位胫神经CSA的正常估计值。
检索谷歌学术、Scopus和PubMed以查找潜在研究。纳入的研究需报告健康个体的胫神经CSA。进行随机效应荟萃分析以计算胫神经CSA值。进行亚组分析和统计分析以研究协变量。
纳入了48篇符合条件的文章，共涉及2695条肢体。发现踝关节处胫神经平均CSA为10.9平方毫米（95%置信区间：9.9 - 11.8），健康成年人不应超过11.8平方毫米。在腘窝处，健康成年人的总体CSA为21.7平方毫米（95%置信区间：17.5 - 25.8）。在这两个部位，成年人胫神经平均CSA均显著大于儿童，且不同地理区域的差异无统计学意义。在踝关节处，胫神经CSA随年龄和体重指数增加，而在腘窝处随年龄和体重增加。
我们的研究结果表明，胫神经不仅在走行过程中存在差异，而且在亚变量之间也存在差异。确立胫神经CSA的正常参考值有助于区分健康与患病的胫神经，如在糖尿病周围神经病变或跗管综合征中。
