Histological validation of ultrasound-guided neurography in early nerve regeneration

• Published in: Muscle & nerve 2009-12, Vol.40 (6), p.967-975
• Main Authors: van Neck, Johan W., de Kool, B. Stefan, Hekking-Weijma, J. (Ineke) M., Walbeehm, Erik T., Visser, Gerhard H., Blok, Joleen H.
• Format: Article
• Language: English
• Subjects: Animals; Axons - diagnostic imaging; Axons - pathology; Biological and medical sciences; Development. Senescence. Regeneration. Transplantation; Diagnostic Techniques, Neurological; Fundamental and applied biological sciences. Psychology; Male; morphometry; nerve conduction studies; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves - diagnostic imaging; Peripheral Nerves - pathology; rabbit; Rabbits; ultrasonography; Ultrasonography - methods; Vertebrates: nervous system and sense organs
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.21405

Ultrasound‐guided near‐nerve neurography is a new tool that can be used to assess nerve regeneration before reinnervation occurs. In this study, ultrasound‐guided near‐nerve measurements were validated against axon diameter counts in rabbits during a 15‐week regeneration period after a crush lesion of their peroneal nerve. The course of the nerve was determined ultrasonically, and the active near‐nerve needle electrode was maneuvered just next to the nerve under ultrasound guidance. Measured action potentials were compared with axon diameter counts from histological sections of these same nerves. A moderate to good positive correlation was found, which reached a maximum of 0.7 at a cut‐off of 3 μm, corresponding to the minimal size of the myelinated axons. Our results suggest that, following a similar validation study in humans, ultrasound‐guided near‐nerve neurography may be clinically useful when early evaluation of nerve activity is needed. Muscle Nerve, 2009