Cha Noah, Zusstone Esther, Ko Lydia, Lee Steve K, J Milani Carlo, Feinberg Joseph H, Wolfe Scott W, Nwawka O Kenechi
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.
New York University Medical Center, New York, NY, USA.
HSS J. 2025 Jan 29:15563316251313807. doi: 10.1177/15563316251313807.
Correct localization and characterization of nerve abnormality is of critical importance to appropriate intervention. Ultrasound (US) is known to be accurate in the diagnosis of peripheral neuropathy and in preoperative localization of nerve abnormalities and skin marking.
We sought to investigate the utility of US-guided preoperative skin marking for the localization of peripheral nerve abnormality and to compare the US findings to electrodiagnostic (EDx) reports.
Using the radiology information system at a single institution, we identified US examinations performed for preoperative localization of peripheral nerve abnormality from July 2016 to March 2023. Data collected included US characterization, surgical description, and EDx report of neuropathy.
Search parameters identified 67 nerves in 55 patients treated surgically after US-guided localization of the nerve with skin marking. The EDx characterization was performed in 36 (54%) of these cases. The US diagnoses included neuroma, transection, perineural scarring, hardware impingement, and intraneural fascicular constriction. There was 100% accuracy of US findings as confirmed by operative notes. Skin marking by US guidance correlated to the sites of the nerve documented in operative reports of all 67 cases.
In this single-institution retrospective review, US-guided preoperative skin marking of nerve abnormality was used to correctly localize peripheral nerve abnormality, and US diagnoses were corroborated by intraoperative findings. Further higher-level study is needed to support these findings suggesting the efficacy of US in mapping the course of peripheral nerves.
准确对神经异常进行定位和特征描述对于恰当的干预至关重要。众所周知，超声（US）在诊断周围神经病变以及术前对神经异常和皮肤标记进行定位方面具有准确性。
我们旨在研究超声引导下术前皮肤标记在周围神经异常定位中的效用，并将超声检查结果与电诊断（EDx）报告进行比较。
利用单一机构的放射学信息系统，我们确定了2016年7月至2023年3月期间为术前周围神经异常定位而进行的超声检查。收集的数据包括超声特征描述、手术描述以及神经病变的电诊断报告。
搜索参数确定了55例患者中的67条神经，这些患者在超声引导下对神经进行皮肤标记后接受了手术治疗。其中36例（54%）进行了电诊断特征描述。超声诊断包括神经瘤、横断、神经周瘢痕形成、硬件压迫以及神经内束状狭窄。手术记录证实超声检查结果的准确率为100%。超声引导下的皮肤标记与所有67例手术报告中记录的神经部位相关。
在这项单一机构的回顾性研究中，超声引导下神经异常的术前皮肤标记用于正确定位周围神经异常，术中发现证实了超声诊断结果。需要进一步开展更高水平的研究来支持这些表明超声在描绘周围神经走行方面有效性的发现。
