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Quantitative ultrasonography in focal neuropathies as compared to clinical and EMG findings
M Bargfrede1, A Schwennicke, H Tumani
1Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.
Objective:
The aim of this study was to assess the diagnostic value of muscle ultrasonography in focal neuropathies.
Subjects And Methods:
100 patients suffering from unilateral symptoms or signs on the extremities indicating injuries of nerve roots, plexus, or peripheral nerves were prospectively examined by manual muscle testing (MMT), electromyography (EMG), and quantitative muscle ultrasonography. Muscle thickness and echointensity (gray scale analysis) were measured and compared to the results from 28 control subjects.
Results:
Ultrasonography was as sensitive as MMT and EMG in detecting muscle involvement. Ultrasonography and EMG were complementary. In 27% of 85 paretic muscles, only one of both techniques revealed pathological findings. Increased echointensity was seen in 82%, atrophy in 31% of pathological muscles. Earliest ultrasonographic abnormalities and pathological spontaneous activity in EMG appeared 10 days after the injury. The inter-observer agreement of ultrasonography was slightly, but significantly lower than that of EMG.
Conclusion:
Muscle ultrasound can visualize anatomical abnormalities such as muscle atrophy and mesenchymal abnormalities in lesions of nerve roots, plexus, and peripheral nerve lesions.