Echogenicity and ultrasound visibility of peripheral nerves of the upper extremity
| Autor: | Parisa P. Javedani, Srikar Adhikari, Lori A Stolz, Amanda M Murphy, Josie Acuña, Kevin Gaskin, Uwe Stolz, Lucas Friedman, Summer Stears-Ellis |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Acoustics and Ultrasonics medicine.medical_treatment Body Mass Index Upper Extremity 03 medical and health sciences Sex Factors 0302 clinical medicine Forearm Diabetes Mellitus medicine Humans Body Weights and Measures Brachial Plexus Radiology Nuclear Medicine and imaging Peripheral Nerves Prospective Studies 030212 general & internal medicine Prospective cohort study Ultrasonography Radiological and Ultrasound Technology business.industry Ultrasound Visibility (geometry) Echogenicity Circumference medicine.anatomical_structure Arm Nerve block Female Radiology business Brachial plexus Neck 030217 neurology & neurosurgery |
| Zdroj: | Medical Ultrasonography. 20:199 |
| ISSN: | 2066-8643 1844-4172 |
| DOI: | 10.11152/mu-1240 |
| Popis: | Aim: Regional anesthesia with ultrasound-guidance is an excellent option for pain control if nerves are adequately visualized. Gender, body mass index (BMI), history of diabetes, neck and forearm circumference may affect echotexture and visualization. This study evaluates patient characteristics for their ability to predict the echogenicity or visibility of upper extremity peripheral nerves.Material and methods: This is a prospective observational study. A convenience sample of adult emergency department patients were enrolled. Gender, BMI, history of diabetes, neck circumference and arm circumference were recorded. Sonographic images of the brachial plexus at interscalene and supraclavicular levels, the median, the radial and ulnar nerves were recorded. Three reviewers independently graded the echogenicity and visibility using subjective scales.Results: 395 peripheral nerves were included. Nerves of the forearm (median, ulnar, radial nerves) were found to be more echogenic (OR=9.3; 95% CI: 5.7, 15.3) and visible (OR=10.0; 6.3, 16.0) than more proximal nerves (brachial plexus at interscalene and supraclavicular levels). Gender, BMI, and history of diabetes mellitus were not significantly related to nerve visibility (p=0.9, 0.2, 0.2, respectively) or echogenicity (p=0.3, 0.8, 0.3). Neck circumference was not related to visibility or echogenicity of proximal nerves. Increased forearm circumference improved echogenicity (OR=1.25; 1.09, 1.43) but not visibility of forearm nerves.Conclusions: Gender, BMI and presence of diabetes were not related to echogenicity or visibility of upper extremity nerves. Increasing forearm circumference was associated with increased echogenicity of the adjacent nerves, but not visibility. Neck circumference was not associated with either nerve visibility or echogenicity of brachial plexus nerve bundles. |
| Databáze: | OpenAIRE |
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