Abstract
Ultrasound shear wave elastography (SWE) is an increasingly used imaging modality that expands clinical ultrasound by measuring the elasticity of various tissues, such as the altered elasticity of tumors. Peripheral nerve tumors are rare, have been well-characterized by B-mode-ultrasound, but have not yet been investigated with SWE. Given the lack of studies, a first step would be to investigate homogeneous peripheral nerve tumors (PNTs), histologically neurofibromas or schwannomas, which can occur in multiple in neurofibromatosis type 1 and 2 (NF1 and 2), respectively. Hence, we measured shear wave velocity (SWV) in 30 PNTs of 11 patients with NF1 within the median nerve. The SWV in PNTs ranged between 2.8 ± 0.8 m/s and correlated with their width and approximate volume but not with their length or height. Furthermore, we determined the extent to which PNTs alter the SWV of the median nerve for three positions of the wrist joint: neutral (zero-degree), individual maximal flexion and maximal extension. Here, SWV was decreased in NF1 patients compared to age- and sex-matched controls (p = 0.029) during maximal wrist extension. We speculate that the presence of PNTs may have a biomechanical impact on peripheral nerves which has not been demonstrated yet.
Highlights
Elasticity of biological tissues change due to many factors, such as tumors, inflammation [1], and fibrosis [2]
Given the lack of studies in the field of peripheral nerve tumors (PNTs), our study aims to expand the spectrum of shear wave elastography (SWE) by investigating homogenous nerve tumors in NF1
There was a significant correlation between the measured shear wave velocity (SWV) in PNTs and width (−0.697, p = 0.017) as well as between SWV in PNTs and approximate volume (−0.728, p = 0.026)
Summary
Elasticity of biological tissues change due to many factors, such as tumors, inflammation [1], and fibrosis [2]. Ultrasound shear wave elastography (SWE) provides measures of such altered elasticity and is already widely used for radiological staging of liver fibrosis [3], neoplastic changes in elasticity of breast cancer [4,5] and thyroid nodules [6]. As the speed of the propagating shear increases or decreases in relation to the elasticity of the tissue and can be tracked in real-time, quantitative two-dimensional maps of the shear wave velocity (SWV) or the shear modulus can be visualized (the shear modulus is quadratically related to the SWV). We first investigated the feasibility of SWE and its potential utility for estimating the elasticity of peripheral nerve tumors (PNTs)
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