An ultrasound study of anatomic variants of the sural nerve
ABSTRACT There are anatomic variations of the sural nerve (SN). Knowledge of these morphological types and the length of the SN are important for planning surgical reconstruction of peripheral nerves. Our purpose was to classify the morphological types of the SN by using ultrasound.
Two-hundred SNs in 100 normal subjects were examined by ultrasound with 13-MHz linear-array transducers. Classification of the SN was evaluated by its formation. The distance between the union and the distal point of the lateral malleolus was measured.
SN variants could be classified into three types: type I (81%); type II (18%); and type III (1%). In type I, the average length of the SN was 15.8 ± 5.7 cm.
The morphological types of the SN can be determined using ultrasound. Ultrasound classification of the SN is useful with regard to donor nerve surgical reconstruction of peripheral nerves.
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ABSTRACT: The application of 22-MHz high-frequency ultrasound allows for visualization of the inner part of the sural nerve. The aim of this study was to evaluate the morphological changes of sural nerves in patients with type 2 diabetes mellitus using ultrasound. The thickness/width (T/W) ratio, the cross-sectional area (CSA) of the sural nerves and the maximum thickness (MT) of the nerve fascicles were measured in 100 patients with type 2 diabetes mellitus and 50 healthy volunteers using 22-MHz ultrasound. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cut-off values as well as the sensitivities and specificities. All parameters were significantly different between the subject and control groups. The ROC curves demonstrated that the MT was the most predictive of diabetic cutaneous neuropathy, with an optimal cut-off value of 0.365 mm that yielded a sensitivity of 90.3% and a specificity of 87.7%. The results of this study suggest that 22-MHz ultrasound may be a valuable tool for evaluating diabetic cutaneous nerve neuropathy.PLoS ONE 04/2012; 7(4):e32730. DOI:10.1371/journal.pone.0032730 · 3.53 Impact Factor
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ABSTRACT: Introduction: The aim of this study was to evaluate the ultrasound (US) morphological changes of sural nerves (SNs) of uremic patients on hemodialysis. Methods: Sixty-six SNs in 33 uremic patients were examined by 22-MHZ high-frequency US and routine nerve conduction studies (NCS), and 76 SNs in 38 controls were also examined. Cross-sectional area (CSA) and maximal fascicular thickness (MFT) of the SNs were measured. Results: The inner parts of the SN were clearly identified in all participants. There were significant increases in CSA and MFT in the patient group (1.86 ± 0.53 mm(2) and 0.37 ± 0.08 mm, respectively) compared with the control group (1.38 ± 0.25 mm(2) and 0.32 ± 0.03 mm, respectively) (P < 0.001). Fifty-seven SNs (86.36%) had abnormal CSAs, and 51 SNs (77.27%) had abnormal MFTs in the patient group, which was higher than NCS abnormalities (66.67%). Conclusions: A 22-MHZ US can show morphological changes in the SNs of uremic patients and may be a valuable tool. Muscle Nerve, 2012.Muscle & Nerve 12/2012; 46(6). DOI:10.1002/mus.23418 · 2.31 Impact Factor
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ABSTRACT: OBJECTIVE: Nerve ultrasound (US) has been used to study peripheral nerve disease, and increase of the cross-sectional area (CSA) has been described in demyelinating polyneuropathy. The objective of the current study is to characterise the US features of the sural nerve in a sample of Charcot-Marie-Tooth (CMT) 1A patients. METHODS: A total of 20 CMT1A patients were enrolled. As control group we studied 37 age- and sex-matched subjects. All patients underwent clinical examination, neurophysiology and US evaluation of the bilateral sural nerve and right ulnar nerve. US results were correlated with neurophysiology and clinical data. RESULTS: Sural nerve CSA was not increased in the majority of patients (70%), whereas an increased ulnar nerve CSA was present in the whole sample. Inverse relations were found between CSA of the ulnar nerve and body mass index (BMI) (p<0.0002, R=-0.8) and CSA of the sural nerve and age (right 0.006, R=-0.6, left 0.002, R=-0.6 and left and right p=0.00003, R=-0.4). CONCLUSIONS: US showed ulnar CSA enlargement and normal sural nerve CSA. SIGNIFICANCE: The significance of normal sural nerve CSA in CMT1A patients need to be further investigated, possibly through longitudinal studies.Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 05/2013; 124(8). DOI:10.1016/j.clinph.2013.02.020 · 2.98 Impact Factor