Foesleitner Olivia, Kirchner Marietta, Preisner Fabian, Kronlage Moritz, Godel Tim, Jende Johann M E, Hilgenfeld Tim, Heiland Sabine, Wick Wolfgang, Bendszus Martin, Schwarz Daniel
Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.
Institute of Medical Biometry, University of Heidelberg, INF 130.3, 69120 Heidelberg, Germany.
Radiology. 2025 Mar;314(3):e232063. doi: 10.1148/radiol.232063.
Background High-resolution imaging methods contribute important pathomorphological information in diagnosing peripheral nerve disorders, but their diagnostic roles remain unclear due to limited clinical evidence. Purpose To investigate the diagnostic performance of high-resolution nerve US (HRUS) and MR neurography (MRN). Materials and Methods This prospective observational, single-center cohort study included 800 patients referred for clinically suspected peripheral neuropathy of the upper extremity from November 2015 to February 2022. All patients underwent both HRUS and MRN, performed and interpreted independently by experienced neuroradiologists. Accuracy, sensitivity, and specificity of HRUS and MRN in diagnosing peripheral neuropathy correctly were calculated in reference to the final diagnosis, based on compound results of clinical, electrophysiological, imaging, and surgical/histopathological findings and compared by means of the McNemar's test and X-Testing. Results In total 800 patients (431 male, 369 female; mean age 47.8 ± 16.5 years) were included. Overall, MRN provided higher accuracy (85.4% [95%CI: 82.7%, 87.8%] vs. 70.6% [95%CI: 67.3%, 73.8%], <.001) and sensitivity (91.6% [95%CI: 89.1%,93.7%] vs. 68.7% [95%CI: 64.8%,72.3%], <.001), while HRUS achieved higher specificity (76.0% [95%CI: 69.4%,81.9%] vs. 66.2% [95%CI: 59.1%,72.8%], <.001) for diagnosing peripheral neuropathy correctly. Conclusion For diagnosing peripheral neuropathies of the upper extremity, MRN achieved higher accuracy and sensitivity while HRUS achieved higher specificity. See also the editorial by Deshmukh in this issue.
背景 高分辨率成像方法在诊断周围神经疾病中可提供重要的病理形态学信息，但由于临床证据有限，其诊断作用仍不明确。目的 探讨高分辨率神经超声（HRUS）和磁共振神经成像（MRN）的诊断性能。材料与方法 这项前瞻性观察性单中心队列研究纳入了2015年11月至2022年2月因临床怀疑上肢周围神经病变而转诊的800例患者。所有患者均接受了HRUS和MRN检查，由经验丰富的神经放射科医生独立进行操作和解读。根据临床、电生理、影像学及手术/组织病理学检查结果的综合结果，以最终诊断为参照，计算HRUS和MRN正确诊断周围神经病变的准确性、敏感性和特异性，并通过McNemar检验和X检验进行比较。结果 共纳入800例患者（男性431例，女性369例；平均年龄47.8±16.5岁）。总体而言，MRN的准确性（85.4%[95%CI：82.7%，87.8%]对70.6%[95%CI：67.3%，73.8%]，P<.001）和敏感性（91.6%[95%CI：89.1%，93.7%]对68.7%[95%CI：64.8%，72.3%]，P<.001）更高，而HRUS在正确诊断周围神经病变方面具有更高的特异性（76.0%[95%CI：69.4%，81.9%]对66.2%[95%CI：59.1%，72.8%]，P<.a001）。结论 对于诊断上肢周围神经病变而言，MRN具有更高的准确性和敏感性，而HRUS具有更高的特异性。另见本期Deshmukh的社论。
