Nerve ultrasound normal values – Readjustment of the ultrasound pattern sum score UPSS

Publication date: July 2018
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Alexander Grimm, Hubertus Axer, Bianka Heiling, Natalie Winter
ObjectiveReference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted.MethodsUltrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated.ResultsOverall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum.ConclusionsThe influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful.SignificanceAdjusted reference values improve the accuracy of the UPSS.



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