Sonographic characteristics of non-traumatic focal hourglass-like nerve constriction

Abstract

Objective. To describe the sonographic phenomenon of the focal «hourglass-like constriction» of the peripheral nerves (FCPN). Material and methods. The authors described 7 patients meeting the criteria for the diagnosis of neuralgic amyotrophy with unilateral FCPN identified with ultrasound in 4 cases and detected intraoperatively in 3 cases (preliminary ultrasound was not per-formed). The US scanner Sonoscape Pro mode gray scale in the transverse and longitudinal scanning, linear probe 8—15 MHz and Logiq9 scanner with elastography were used. Results. FCPN was detected in the single nerve in 4 patients, in two nerves in 2 patients and in 3 nerves in one patient. Among all the nerves involved in the pathological process, the radial nerve and its branches were affected in 73% (8 nerves); the ulnar nerve was involved in 18% (2 nerves) and the musculo-cutaneous nerve in 9%. The length of the constriction of the peripheral nerve did not exceed 1.7 mm. The deformation coefficient (DC) of constriction area was 3.8 to .,9; the change in the elasticity in the form of an increase of DC to 5.9 when compared to the intact portion of the nerve and a decrease in echogenicity were observed in one patient. Conclusion. High-resolution ultrasound of the nerve can be an informative method for the diagnosis of idiopathic non-traumatic FCPN mononeuropathy.