Telleman Johan A, Sneag Darryl B, Visser Leo H
Department of Neurology and Clinical Neurophysiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States.
Handb Clin Neurol. 2024;201:19-42. doi: 10.1016/B978-0-323-90108-6.00001-6.
Electrodiagnostic testing (EDX) has been the diagnostic tool of choice in peripheral nerve disease for many years, but in recent years, peripheral nerve imaging has been used ever more frequently in daily clinical practice. Nerve ultrasound and magnetic resonance (MR) neurography are able to visualize nerve structures reliably. These techniques can aid in localizing nerve pathology and can reveal significant anatomical abnormalities underlying nerve pathology that may have been otherwise undetected by EDX. As such, nerve ultrasound and MR neurography can significantly improve diagnostic accuracy and can have a significant effect on treatment strategy. In this chapter, the basic principles and recent developments of these techniques will be discussed, as well as their potential application in several types of peripheral nerve disease, such as carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), radial neuropathy, brachial and lumbosacral plexopathy, neuralgic amyotrophy (NA), fibular, tibial, sciatic, femoral neuropathy, meralgia paresthetica, peripheral nerve trauma, tumors, and inflammatory neuropathies.
多年来，电诊断测试（EDX）一直是诊断周围神经疾病的首选工具，但近年来，周围神经成像在日常临床实践中的使用越来越频繁。神经超声和磁共振（MR）神经造影能够可靠地显示神经结构。这些技术有助于定位神经病变，并能揭示神经病变背后可能未被EDX检测到的显著解剖异常。因此，神经超声和MR神经造影可以显著提高诊断准确性，并对治疗策略产生重大影响。在本章中，将讨论这些技术的基本原理和最新进展，以及它们在几种周围神经疾病中的潜在应用，如腕管综合征（CTS）、肘部尺神经病变（UNE）、桡神经病变、臂丛和腰骶丛病变、神经性肌萎缩（NA）、腓总神经、胫神经、坐骨神经、股神经病变、股外侧皮神经痛、周围神经损伤、肿瘤和炎性神经病变。
