Diagnostic accuracy of ultrasound and MR imaging in peroneal neuropathy: A prospective, single-center study.

Autor: Oosterbos C; Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, Leuven, Belgium.; Department of Neurosurgery, Ziekenhuis Oost-Limburg, Genk, Belgium., Weerdt O; Department of Radiology, University Hospitals Leuven, Leuven, Belgium., Lembrechts M; Department of Radiology, University Hospitals Leuven, Leuven, Belgium., Radwan A; Department of Radiology, University Hospitals Leuven, Leuven, Belgium., Brys P; Department of Radiology, University Hospitals Leuven, Leuven, Belgium., Brusselmans M; Department of Public Health and Primary Care, I-BioStat, Leuven, Belgium.; I-BioStat, UHasselt, Hasselt, Belgium., Bogaerts K; Department of Public Health and Primary Care, I-BioStat, Leuven, Belgium.; I-BioStat, UHasselt, Hasselt, Belgium., Peeters R; Department of Radiology, University Hospitals Leuven, Leuven, Belgium., Van Hoylandt A; Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, Leuven, Belgium.; Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium., Hoornaert S; Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, Leuven, Belgium.; Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium., Lemmens R; Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.; Department of Neurology, University Hospitals Leuven, Leuven, Belgium., Theys T; Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, Leuven, Belgium.; Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: Muscle & nerve [Muscle Nerve] 2024 Sep; Vol. 70 (3), pp. 360-370. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1002/mus.28187
Abstrakt: Introduction/aims: Magnetic resonance imaging (MRI) findings in peroneal neuropathy are not well documented and the prognostic value of imaging remains uncertain. Upper limits of cross-sectional area (CSA) on ultrasound (US) have been established, but uncertainty regarding generalizability remains. We aimed to describe MRI findings of the peroneal nerve in patients and healthy controls and to compare these results to US findings and clinical characteristics.
Methods: We prospectively included patients with foot drop and electrodiagnostically confirmed peroneal neuropathy, and performed clinical follow-up, US and MRI of both peroneal nerves. We compared MRI findings to healthy controls. Two radiologists evaluated MRI features in an exploratory analysis after images were anonymized and randomized.
Results: Twenty-two patients and 38 healthy controls were included. Whereas significant increased MRI CSA values were documented in patients (mean CSA 20 mm 2 vs. 13 mm 2 in healthy controls), intra- and interobserver variability was substantial (variability of, respectively, 7 and 9 mm 2 around the mean in 95% of repeated measurements). A pathological T2 hyperintense signal of the nerve was found in 52.6% of patients (50% interobserver agreement). Increased CSA measurements (MRI/US), pathological T2 hyperintensity of the nerve and muscle edema were not predictive for recovery.
Discussion: Imaging is recommended in all patients with peroneal neuropathy to exclude compressive intrinsic and extrinsic masses but we do not advise routine MRI for diagnosis or prediction of outcome in patients with peroneal neuropathy due to high observer variability. Further studies should aim at reducing MRI observer variability potentially by semi-automation.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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