Ultrasound pattern sum score, homogeneity score and regional nerve enlargement index for differentiation of demyelinating inflammatory and hereditary neuropathies
| Autor: | Debora Vittore, Alexander Grimm, Bernhard F. Décard, Christina Lipski, Victoria Schubert, Bianka Heiling, Hubertus Axer |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male Pathology medicine.medical_specialty Neural Conduction Chronic inflammatory demyelinating polyneuropathy Nerve conduction velocity Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Charcot-Marie-Tooth Disease Physiology (medical) medicine Humans Peripheral Nerves Tibial nerve Metre per second Aged Ultrasonography medicine.diagnostic_test business.industry Ultrasound Middle Aged medicine.disease Sensory Systems Surgery 030104 developmental biology Neurology Polyradiculoneuropathy Chronic Inflammatory Demyelinating Nerve conduction study Female Neurology (clinical) business Polyneuropathy 030217 neurology & neurosurgery Multifocal motor neuropathy |
| Zdroj: | Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 127(7) |
| ISSN: | 1872-8952 |
| Popis: | To investigate the use of nerve ultrasound in the differentiation between Charcot-Marie Tooth hereditary neuropathy (CMT1) and chronic inflammatory demyelinating polyradiculoneuropathies (CIDP), multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor neuropathies (MADSAM).Ultrasound/electrophysiology of predefined nerves was performed in CMT1a/b, immunoneuropathies, and healthy controls. Ultrasound pattern sum score (UPSS, sum of the amount of 12 predefined measurement points), homogeneity score (HS) and regional nerve enlargement index (RNEI) in ulnar, median, and tibial nerve were used for evaluation of morphology.13 CMT1, 27 CIDP, 10 MADSAM, 12 MMN, and 23 controls were included. Significant enlargement was shown in all neuropathies compared to the controls, (p0.001), however the amount of enlargement as evaluated by the UPSS was most prominent in CMT compared to the others (median UPSS 18 vs. 11/8.5/5 in CIDP/MADSAM/MMN, p0.001). Homogeneous enlargement was significantly more often seen in CMT (67%, HS 6 vs. 2-3 in immune-mediated PNP, p0.001), while in CIDP the enlargement was regional, homogeneous or inhomogeneous with equal contribution. In MMN and MADSAM regional enlargement (48%/40%) next to normal segments (∼20%) predominated (RNEI in MMN=2, in MADSAM=1 vs. 0 in the others). CSAs were inversely correlated with motor conduction velocity.Ultrasound, quantified by UPSS, HS, and RNEI facilitates a reliable and reproducible differentiation of immunoneuropathies and hereditary neuropathies by the use of boundary values.By the use of quantitative scores, ultrasound differentiation of demyelinating neuropathies is operationalized and ameliorated compared to CSA measurements only. |
| Databáze: | OpenAIRE |
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