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Abstract

Peripheral nerve injuries significantly impact patients’ quality of life and place a burden on healthcare resources. This review explores the application of high-resolution neurosonography (HRNUS) in mapping peripheral nerves and identifying pathological lesions.

It underscores HRNUS’s role in diagnosing nerve disorders and outlines widely accepted classification schemes for peripheral nerve injuries.

The article highlights HRNUS’s non-invasive, flexible, patient-friendly, and cost-effective attributes, advocating for its use to achieve accurate diagnoses, prevent permanent disabilities, and optimize healthcare resource utilization.

Key Points

• High-resolution neurosonography (HRNUS) serves as an effective and economical tool for mapping peripheral nerve injuries.​

• HRNUS enhances diagnostic accuracy for neural and peri-neural lesions.​

• The review provides a practical guide for radiologists employing HRNUS to detect peripheral nerve lesions.

Introduction

Peripheral nerve injuries are debilitating conditions with long-term adverse effects on patients and healthcare systems. Accurate localization of such injuries traditionally relies on clinical neurological assessments, neurophysiological studies, and advanced imaging techniques.

While Magnetic Resonance Imaging (MRI) has been the conventional modality for evaluating peripheral nerve pathologies, particularly for deep nerves, ultrasound has emerged as the preferred method for imaging superficial peripheral nerves due to its non-invasive, dynamic, patient-friendly, and cost-effective nature.

Despite its advantages, many radiologists remain unfamiliar with using ultrasound for detecting peripheral nerve lesions, leading to its underutilization in clinical practice.

Epidemiology of Peripheral Nerve Injuries

Although peripheral nerve injuries are relatively rare, their incidence has risen in recent decades, with a prevalence rate of approximately 2–3% according to recent trauma registries. These injuries predominantly affect the digital, median, and ulnar nerves in the upper extremities, and the plantar and peroneal nerves in the lower extremities.

Notably, iatrogenic causes account for about one-third of these cases. Early identification of peripheral nerve injuries is crucial for appropriate patient management, achieving optimal outcomes, and ensuring efficient use of healthcare resources.

Peripheral Nerve Imaging Overview

Imaging evaluation of peripheral nerves is guided by neurological assessments and electrodiagnostic studies that provide insights into nerve function. Magnetic Resonance Neurography (MRN) is considered the gold standard for imaging neural plexuses and their peripheral branches.

However, High-Resolution Neurosonography (HRNUS) has proven to be a valuable, cost-effective tool for mapping peripheral nerves, detecting pathological lesions, and guiding procedures such as nerve injections and biopsies of peri-neural lesions.

READ MORE HERE: https://theultrasoundjournal.springeropen.com/articles/10.1186/s13089-024-00387-0

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