High-Resolution US vs MR Neurography for Diagnosis of Upper Extremity Peripheral Nerve Disorders

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• High-resolution imaging methods are crucial for diagnosing peripheral nerve disorders.
• Limited clinical evidence currently hinders the full understanding of their diagnostic roles.
• Peripheral neuropathies require accurate diagnostic tools for effective management.

Purpose of the Study:

• To compare the diagnostic performance of high-resolution nerve ultrasound (HRUS) and MR neurography (MRN).
• To evaluate the accuracy, sensitivity, and specificity of HRUS and MRN in diagnosing peripheral neuropathy of the upper extremity.

Main Methods:

• Prospective observational, single-center cohort study including 800 patients with suspected upper extremity peripheral neuropathy.
• All patients underwent both HRUS and MRN, interpreted independently by experienced neuroradiologists.
• Diagnostic performance metrics were calculated against a final diagnosis based on comprehensive clinical, electrophysiological, imaging, and pathological findings.

Main Results:

• MR neurography (MRN) demonstrated higher overall accuracy (85.4%) and sensitivity (91.6%) compared to HRUS (70.6% accuracy, 68.7% sensitivity).
• High-resolution nerve ultrasound (HRUS) achieved higher specificity (76.0%) than MRN (66.2%).
• Statistical analysis confirmed significant differences in accuracy and sensitivity favoring MRN, and in specificity favoring HRUS (P<.001).

Conclusions:

• MR neurography (MRN) offers superior accuracy and sensitivity for diagnosing peripheral neuropathies of the upper extremity.
• High-resolution nerve ultrasound (HRUS) provides higher specificity in diagnosing these conditions.
• The findings highlight the complementary roles of HRUS and MRN in the diagnostic workup of peripheral nerve disorders.