Comparison of Electrodiagnosis, Neurosonography and MR Neurography in localization of Ulnar Neuropathy at the Elbow.

Ho, Michael J; Held, Ulrike; Steigmiller, Klaus; Manoliu, Andrei; Schiller, Andreas; Hinzpeter, Ricarda; Lanz, Christian; Martinoli, Carlo; Jung, Hans H; Petersen, Jens A (2022). Comparison of Electrodiagnosis, Neurosonography and MR Neurography in localization of Ulnar Neuropathy at the Elbow. Journal of neuroradiology, 49(1), pp. 9-16. Elsevier Masson 10.1016/j.neurad.2021.05.004

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INTRODUCTION

In patients with ulnar neuropathy at the elbow (UNE) the precise determination of the site of lesion is important for subsequent differential diagnostic considerations and therapeutic management. Due to a paucity of comparable data, to better define the role of different diagnostic tests, we performed the first prospective study comparing the diagnostic accuracy of short segment nerve stimulation, nerve ultrasonography, MR neurography (MRN), and diffusion tensor imaging (DTI) in patients with UNE.

METHODS

UNE was clinically diagnosed in 17 patients with 18 affected elbows. For all 18 affected elbows in patients and 20 elbows in 10 healthy volunteers, measurements of all different diagnostic tests were performed at six anatomical positions across the elbow with measuring points from distal (D4) to proximal (P6) in relation to the medial epicondyle (P0). Additional qualitative assessment regarding structural changes of surrounding nerve anatomy was conducted.

RESULTS

The difference between affected arms of patients and healthy control arms were most frequently the largest at measure intervals D2 to P0 and P0 to P2 for electrophysiological testing, or measure points P0 and P2 for all other devices, respectively. At both levels P0 and at P2, T2 contrast-to-noise ratio (CNR) of MRN and mean diffusivity (MD) of DTI-based MRN showed best accuracies.

DISCUSSION

This study revealed differences in diagnostic performance of tests concerning a specific location of UNE, with better results for T2 contrast to noise ratio (CNR) in MRN and mean diffusivity of DTI-based MRN. Additional testing with MRN and nerve ultrasonography is recommended to uncover anatomical changes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ho, Michael Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0150-9861

Publisher:

Elsevier Masson

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

08 Jun 2021 10:00

Last Modified:

05 Dec 2022 15:51

Publisher DOI:

10.1016/j.neurad.2021.05.004

PubMed ID:

34023361

Uncontrolled Keywords:

DTI MR Neurography elbow nerve ultrasound ulnar nerve ulnar neuropathy

BORIS DOI:

10.48350/156492

URI:

https://boris.unibe.ch/id/eprint/156492

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