Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.
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A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation Valentina Paggi, Florian Fallegger, Ludovic Serex, Olivier Rizzo, Katia Galan, Alice Giannotti, Ivan Furfaro, Ciro Zinno, Fabio Bernini, Silvestro Micera, Stéphanie P. Lacour Bioelectronic Medicine.2024;[Epub] CrossRef
Carotid duplex ultrasound is commonly used to diagnose various carotid artery diseases due to it being noninvasive and easy to perform. Carotid atherosclerosis is a major indicator for the need to perform carotid duplex ultrasound, which can determine the degree of stenosis, plaque characteristics, and intima-media thickness. It can also be used to screen and follow-up after carotid revascularization. Here we discuss the standard techniques, interpretations, and clinical indicators for carotid duplex ultrasounds.
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The diagnosis and treatment of asymptomatic and symptomatic patients with carotid artery stenosis Robert J. Henning, Brian L. Hoh Current Problems in Cardiology.2025; 50(6): 102992. CrossRef
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Ultrasound Score of Liver Steatosis Severity in the Diagnosis of Peripheral Arterial Atherosclerosis in Patients with Nonalcoholic Fatty Liver Disease A. S. Kuznetsova, A. I. Dolgushina, V. V. Pospelov, T. A. Sokolova, E. V. Lebedev, V. V. Genkel The Russian Archives of Internal Medicine.2023; 13(3): 196. CrossRef
The Use of Ultrasound for Detecting the Association Between Endothelial Dysfunction and lp13.3 Genomic Region rs646776 Polymorphism in Patients With Rheumatoid Arthritis From the Suez Canal Region Afaf Ahmed, Aziza Omar, Maivel Ghattas, Mona Ghaly, Mohammad al-Shatouri Cureus.2023;[Epub] CrossRef
Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA): A Systematic Review and Meta-Analysis Simon Takadiyi Gunda, Nonhlanhla Chambara, Xiangyan Fiona Chen, Marco Yiu Chung Pang, Michael Tin-cheung Ying Children.2022; 9(11): 1676. CrossRef
Background The median-to-ulnar comparison test (MUCT), and increasingly, ultrasonography (US) are considered as complementary to and more sensitive than median nerve conduction study (NCS) in diagnosing carpal tunnel syndrome (CTS).
Methods In consecutive patients with hand paresthesia compatible with CTS but with normal median NCS, we additionally performed the MUCT and analyzed whether it yielded better diagnostic sensitivity.
Results In total, 163 hands of clinically diagnosed CTS patients were examined with routine NCS. The MUCT and US were performed in 81 hands and 31 hands, respectively. While median NCS was diagnostic in 85 (52.1%) hands, MUCT failed to demonstrate superior sensitivity over median NCS in the other hands and US revealed related abnormalities better than both routine NCS (p=0.006) and MUCT (p=0.002).
Conclusions The MUCT offered no additional diagnostic benefit. On the other hand, sonographic examination had higher sensitivity for the diagnosis of CTS when applying several diagnostic criteria. Thus, US could be the screening test for diagnosing CTS prior to NCS with higher sensitivity than MUCT. However, further studies are needed to define the appropriate diagnostic criteria for US.
Neuromuscular ultrasonography has emerged over the last decade as a useful tool for diagnosing peripheral nerve disorders. It has been studied extensively with a particular focus on the assessment of compression neuropathies. Neuromuscular ultrasonography complements electrodiagnostic studies well by visualizing both the nerve anatomy and surrounding structures, providing useful data that cannot be obtained using the latter methodology only. This review article summarizes and synthesizes the literature focusing on the diagnostic role of neuromuscular ultrasonography in common compression neuropathies of the upper limb.
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Residual limb neuropathic pain association with neuroma, prosthetic, function, and participation outcomes in individuals living with a transtibial amputation: an exploratory study Camille Fournier-Farley, Mathieu Boudier-Revéret, Dany H. Gagnon Journal of Rehabilitation Medicine.2025; 57: jrm40551. CrossRef
Evaluation of diaphragm function is challenging because no single test has a high diagnostic yield. We describe ultrasound findings in three cases with acquired unilateral diaphragmatic elevation. These cases confirm that sonographic evaluation is a valid tool for identifying diaphragm dysfunction. In addition, ultrasound measurements of diaphragm thickness and the
contractility can be used to determine if a diaphragm is paralyzed and suggest the duration of paralysis (i.e., acute or chronic).
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Clinical and sonographic evaluation of the diaphragm after plication in adults with unilateral eventration: a retrospective study Mohamed Abdel-Bary, Alaa Rashad, Hamed Elgendy, Mohammed Zaki, Mahmoud Youssef Abdelhamid, Morris Beshay, Khaled Mohamed Abdelaal The Egyptian Journal of Bronchology.2022;[Epub] CrossRef
Ultrasound Imaging of the Diaphragm Jung Im Seok Journal of the Korean Neurological Association.2021; 39(4): 270. CrossRef
Neuromuscular Ultrasound in Amyotrophic Lateral Sclerosis Jung Im Seok Journal of Neurosonology and Neuroimaging.2019; 11(1): 73. CrossRef
Background Pulsatility of cerebral arteries and aortic stiffness have been associated with
white matter hyperintensities (WMH). We explored which is better correlated with the severity of WMH in a population with acute lacunar infarct.
Methods We included patients with acute small subcortical infarcts who underwent transcranial Doppler (TCD) and brachial ankle pulse wave velocity (baPWV). Exclusion criteria were any stenosis or occlusion on major cerebral arteries on magnetic resonance angiography; poor temporal insonation windows; ankle brachial index < 0.9; and atrial fibrillation. We assessed the performance of the pulsatility index of bilateral middle cerebral arteries (PI-MCA) and baPWV for predicting moderate-to-severe WMH, defined as an Age Related White Matter Changes score > 5, and then sought to find independent predictors using binary logistic regression analysis.
Results Eighty-three patients (56 males, mean age 61.5 ± 11.4) participated in the study. Univariate analysis showed old age and high PI-MCA were significantly correlated with moderate-to-severe WMH. However, baPWV was not associated with the severity of WMH. Multivariate analysis revealed old age (odds ratio per 1-year increase, 1.068; p = 0.044) and upper tertile of PI-MCA (odds ratio, 5.138; p = 0.049) were independently associated with moderate-to-severe WMH. Receiver-operating characteristics showed PI-MCA differentiated those with and without moderate-to-severe WMH with an area under the curve of 0.719.
Conclusions PI-MCA derived from TCD was better correlated with the severity of WMH than baPWV in a population with lacunar infarction. Pulsatility of cerebral arteries may better predict cerebral small vessel disease than the aortic stiffness index.
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Distinct association between cerebral arterial pulsatility and subtypes of cerebral small vessel disease Ki-Woong Nam, Hyung-Min Kwon, Yong-Seok Lee, Masaki Mogi PLOS ONE.2020; 15(7): e0236049. CrossRef
Characterizing pulsatility in distal cerebral arteries using 4D flow MRI Tomas Vikner, Lars Nyberg, Madelene Holmgren, Jan Malm, Anders Eklund, Anders Wåhlin Journal of Cerebral Blood Flow & Metabolism.2020; 40(12): 2429. CrossRef
Persistent left superior vena cava (PLSVC) is a common venous anomaly of the thorax and usually drains into the right atrium. Less often it drains into the left atrium and has previously been related to ischemic stroke. We report a case of PLSCV that founded during ischemic
stroke evaluation in a 77-year-old woman which was detected on transesophageal echocardiography (TEE) and transcranial Doppler ultrasonography (TCD) with saline agitated test and computed tomography.
Ulnar neuropathy at the elbow (UNE) may seem easy to diagnose when the characteristic clinical manifestations are present, and electrodiagnostic studies have high sensitivity, although they are non-localizing in some cases and unable to reveal structural lesions. Ultrasonography is noninvasive and able to find the exact location of the lesion and visualize perineural structures. We present two cases of UNE in which we found hypoechoic mass lesions near medial epicondyle with ultrasonography and discuss its usefulness in diagnosis of UNE.
Background : The origin of p300 was still on debate n\but thought to be in the frontal, temporal or parietal lobe. As the transcranial doppler ultrasonography(TCD) gives us and opportunity to observe hemodynamic chaged dynamically and the middle cerebral artery feeds these ares of the hemisphere, we observed the change of mean flow velocity of MCA during the event related potential test(ERP) to determine the role of these structures in P300 generation. Method : Twenty normal subjects(male : 13, age : 24-29 years) performed ERP. An auditory oddball pardigm was used to elicit the ERPs. TCD examination was performed with 2-MHz probe monitoring the left MCA(Transscan, EME). After signal identification and adjustments to maximize the Doppler signal strength, the probe was mechanically locked during the monitoring. The changes of blood flow velocity of the left middle cerebral artery(MCA) induced by cognitive demands were monitored. The measurement of the meal flow velocities(MFV) of MCA were made while the subjects were prior to, during, and after ERP. We recorded the MFVs during ERP. Statistical analysis was performed using t-tests with SPSS-PC for windows release 6.0. Results : All subjects showed a relative increase in MFV of MCA during the task. The mean rise was about 3.2-4.2%(p <0.05). Although TCD does not measure absolute values of regional cerebral blood flow(rCBF) or absolute rCBF changes, changes of flow velocity can reflect relative rCBF changes. Conclusions : The generation site of P300 still remains unclear but the neocortical, thalamic and limbic region and temporal-parietal cortex have been proposed. The MCA supplies these anatomical structures. The Changes of flow veolocity of MCA during the ERP test suggest that the some part of the brain fed y the MCA activate of the temporal lobe or parietal lobes, we can deduce that some parts of brain fed by the MCA participate in the generation of P300.
Dignosis of migraine is only based on the medical history, and objective methods to aid the clinical diagnosisare absent. Although transcranial Doppler ultrasonography (TCD) abnormalities in headache-free migraineurs have been reported previously, diagnostic criteria for migraine is still lacking and this may limit the practication of TCD for migraine. we prospectively studied several abnormal TCD indices in interictal migraineurs and their sensitivity and specificity to define the optimal diagnostic criteria. Young (20 yrs
Transcranial doppler ultrasonography (TCD) is a new, non-invasive and easily applicable method to evaluate cerebral hemodynamics. Last 10 years, its use in Korea has been dramatically expanded, but the qualification of TCD laboratory has yet to be settled. Since duplex sonography is seldom used in Korea, we have to depend totally on TCD to evaluate cerebral hemodynamic changes. Thus, ll of the available data from every detectabler cerebral arteries has to be obtained for accurate interpretation of TCD measurements. Moreover, flow direction and wave form should be concerned in addition to the flow velocity. In this article, I present technique to measure the anterior, meddle and posterior cerebral arteries, the internal carotid artery siphon and at cervical level, and the vertebral and the basilar artery, and normal values for these measurements which is essential for the adequate interpretation.
Background : Syncope was defined as transient loss of consciousness and postural tone. The mechanisms of changes in cerebral hemodynamics during syncope have not been fully evaluated. Transcranial Doppler Ultrasonography can continuously monitor the changes in cerebral hemodynamics during head-up tilt (HUT). TCD could reveal the different patterns of changes in cerebral hemodynamics during syncope. Syncope without hypotension or bradycardia could be detected by TCD. We investigated the changes in cerebral blood flow velocity during HUT using TCD in 33 patients with a history of recurrent syncope or presyncope of unknown origin. Methods & Results : The positive responses were defined as presyncope or syncope with hypotension, bradycardia, or both. During HUT without isoproterenol infusion, there were a 86?3% drop in DV and a 41?4% drop in SV in 5 patients with positive reponses, and mean changes in those were less than 10% in patients with negative reponses ( p=.00, p=.00). During HUT with isoproterenol infusion, TCD showed a 80?8% drop in diastolic velocity in 14 patients with positive reponses, and a 47?0% drop in that in patients with negative reponses (p=.00), however the change in systolic velocity did not differ. TCD showed three patterns during positive responses; loss of all flow, loss of end diastolic flow, and a decrease in diastolic velocity. Loss of consciousness occurred in the patients with loss of all flow or end-diastolic flow during positive reponses. Conclusions : TCD shows different patterns of changes in cerebral hemodynamics during HUT. TCD can be used to investigate the pathophysiology of neurocardiogenic syncope
The most significant factor in pathogenesis of vascular headaches like migraine and cluster headache is dynamic changes of diameters of the cerebral arteries. TCD is a valuable noninvasive tool to assess the cerebral hemodynamic status by measuring the flow velocities of the intracranial cerebral arteries around the circle of Willis. TCD can evaluate flow velocities and vasoreactivity of the patients with a vascular headache during the ictal phase as well as during intericatal phase. Distribution of the changes recorded differ between types of headaches nd also between the major ictal symptoms. The Changes suggest the presence of prolonged vasospasm interictally and more marked relaxation of the cerebral arteries. TCD can be used to monitor the long-term clinical course of patients with vascular headache by correlation the symptomatic improvement and TCD data before and after long-term pharmacological prophylactic treatments. During the ictal phases large intervention. The results may be used in selecting and evaluating the agents for abortive therapy for acute attacks. In conclusion TCD can quantitatively evaluate vascular headaches when making diagnosis and classification and can provide guidelines to choose more individualized therapeutic options for both acute and long-term treatment
Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. The measure of common carotid artery intima-media thickness (IMT) has been extensively used as an early marker of atherosclerosis. The aim of this study was to test the hypothesis that early signs of atherosclerosis are present in patients with OSA and correlate with OSA severity Methods: Eleven male patients with OSA were studied by using full standard overnight polysomnography and high-definition echo-tracking device to measure intima-media thickness and carotid artery diameter. Eight healthy volunteers matched for age and sex were studied by portable respiratory monitoring device. All participants were free of hypertension, diabetes, and were not on any medications. Patients with OSA were naive to treatment. Results: All patients and normal controls were male. There was no significant difference of age between patients and controls (48.4
Background The aim of this study is to identify the correlation between ultrasonographic findings of median nerve andclinical scale and electrophysiologic data in carpal tunnel syndrome. Methods: Forty three patients (79 hands) with electrophysiologicallyconfirmed carpal tunnel syndrome were evaluated. Clinical symptoms were examined by Historical-Objective(Hi-Ob) scale. Electrophysiologic data and Padua scale were used for severity of electrophysiology. In ultrasonographic study,cross sectional area and flattening ratio of median nerve were measured at distal wrist crease level (DWC), 1cm proximalto distal wrist crease level, and 1cm distal to distal wrist crease level. The correlation between Hi-Ob scale, electrophysiologicdata and ultrasonography was measured with Spearman rank test. Results: The mean Hi-Ob scale was 2.4. Mean Padua scalewas 4.0. In ultrasnonographic study, cross sectional area and flattening ratio were 0.112 cm2
Background Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes.Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascularreactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods:Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significanthistory of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebralartery with better temporal window. Each subject was examined consecutively before and after a standard meal, togetherwith serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI(mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group;postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239,respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serumglucose level of patients showed a tendency of mild positive correlation with BHIs (
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