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45 Median nerve dimensions measured using highresolution ultrasound in healthy volunteers

Published online by Cambridge University Press:  24 June 2014

D. Azman,
R. Bene,
M. Strineka,
J. Bosnjak,
A. Huzjan-Lovrencic,
M. Budisic and
V. Demarin
D. Azman
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
R. Bene
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
M. Strineka
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
J. Bosnjak
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
A. Huzjan-Lovrencic
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
M. Budisic
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
V. Demarin
Affiliation:
University Department of Neurology, Sestre Milosrdnice University Hospital, Reference Center for Neurovascular Disorders and Reference Center for Headache of the Ministry of Health and Social Welfare of the Republic of Croatia, Vinogradska 29, Zagreb, Croatia
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Abstract

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Objectives:

Although electroneuro- and electromyography are still leading diagnostic methods for investigation of peripheral nerves function, they do not provide information regarding their morphology. This study was conducted to evaluate the suitability of ultrasonography in visualization of median nerve in healthy volunteers.

Methods:

Twenty-five asymptomatic volunteers (16 women and 9 men) have participated in this study, age ranging from 2068 years.

Device used was Aloka Prosound Alpha10 Premier with 13MHz probe, using custom preset for musculo-skeletal sonography. Following dimensions of median nerve at the level of pisiform bone were measured bilaterally: cross-sectional area (CSA), circumference, longer and shorter radius. Subsequently, using latter values, flattening ratio was calculated.

Examinees' height was measured and handedness ascertained. Additional epidemiological data taken was the average daily time that individuals spent working on a personal computer as a possible factor for compression of the nerve in examinee's dominant hand.

Results:

Median nerve was easily depicted in all of the participants as well as the surrounding soft-tissue structures. Average CSA of median nerve was 9.67 mm2 (range 5–15 mm2, with standard deviation of 2.4 mm). Mean flattening-ratio (FR) (longer radius/ shorter radius) was 4.18, ranging from 2.16 to 5.92.

Median height was 173.8 cm and only one subject was left-handed while the others (96%) were right hand dominant. Average daily time spent working on a personal computer (total average of 2.96 hours) did not correlate with CSA or FR values for the dominant hand.

Additionally, in two subjects, an aberrant artery accompanying n. medianus was visualized.

Conclusion:

High-resolution sonographic imaging allows assessment of various morphological properties of median nerve, including its various dimensions and echoic architecture. Furthermore, ultrasound imaging is a very convenient (available, quick, inexpensive and noninvasive) method for examination of peripheral nerve morphology and could thus be used to enhance diagnostic efficiency.