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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- "Ultrasonography can identify almost all the main nerves of the limbs. It has been reported on morphologic determination of SN types by ultrasonography or using cadavers [4-6]. However, ultrasonographic evaluations of the course and anatomical variations of the SN for nerve conduction studies have not been documented. "
ABSTRACT: To understand various morphologic types and locations of the sural nerve (SN) that are important for nerve conduction studies or nerve grafting procedures. The aim of this study was to describe the course and variations of the SN based on ultrasonographic findings for an adequate nerve conduction study. A total of 112 SNs in 56 volunteers with no history of trauma or surgery were examined by ultrasonography. The location and formation of the SNs in relation to the medial and lateral sural cutaneous nerve were investigated. We measured the horizontal distance between the SNs and the midline of the calf at the level of 14 cm from the lateral malleolus, and the distance between the SNs and the most prominent part of the lateral malleolus. SN variants was classified into four types according to the medial and lateral sural cutaneous nerve; type 1 (73.2%), type 2 (17.9%), type 3 (8.0%), and type 4 (0.9%). The mean distance between the SN and the midline of the calf was 1.02±0.63 cm, the SN and the most prominent part of the lateral malleolus was 2.14±0.15 cm. Variations in the location and formation of the SN was examined by ultrasonography, and the results of this study would increase the accuracy of the SN conduction study.Annals of Rehabilitation Medicine 02/2014; 38(1):46-51. DOI:10.5535/arm.2014.38.1.46
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- "However, there are some anatomical variants of the SN. We classified the SN into three types using US . Type I was the classic pattern of sural nerve formation, in which both the MSCN and the LSCN contributed to the formation of the SN. "
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 · 3.23 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 12/2012; 46(6). DOI:10.1002/mus.23418 · 2.28 Impact Factor