Ultrasonography has a diagnostic value in the assessment of cervical radiculopathy: A prospective pilot study

Mikinobu Takeuchi,Atsuhiko Hirasawa,Kenta Murotani,Koji Osuka,Masakazu Takayasu,Norimitsu Wakao,Mitsuhiro Kamiya

doi:10.1007/s00330-016-4704-9

Mikinobu Takeuchi, Atsuhiko Hirasawa + Show 5 more

Open Access

https://doi.org/10.1007/s00330-016-4704-9

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Journal: European radiology	Publication Date: Jan 3, 2017
Citations: 16	License type: open-access

Affiliation: Aichi Medical University

Abstract

ObjectiveThis study investigated the diagnostic accuracy of the difference in the cross-sectional areas (CSAs) of affected cervical nerve roots (NRs) for diagnosing cervical radiculopathy (CR).MethodsIn total, 102 CR patients and 219 healthy volunteers were examined with ultrasound. The CSA of the cervical NR at each level was measured on the affected side and the contralateral side in CR patients by blinded ultrasonographic technicians. The difference between the CSAs of CR patients and normal volunteers and the difference in the laterality of CSA at the same affected level (ΔCSA) were calculated for each cervical level.ResultsThe CSAs of the affected NRs in CR patients were significantly larger than those of the unaffected NRs in CR patients and those of the control group at the C5, C6 and C7 levels (P<0.005). ΔCSA was also significantly larger in the CR group at all levels (P<0.001). A receiver operating characteristic analysis demonstrated that the threshold values were 9.6 mm2 (CSA) for C5NR and 15 mm2 for both C6NR and C7NR.ConclusionsThis study revealed that the CSAs of affected NRs were enlarged and that the laterality of the CSA (ΔCSA) was greater in CR patients than in control patients.Key Points• Cervical radiculopathy is diagnosed through ultrasonographic measurement of the CSAs.• The CSAs of affected nerve roots were significantly enlarged.• The ΔCSA in the CR group was significantly higher than in the control group.• Diagnostic CSA and ΔCSA thresholds were identified.

Highlights

Magnetic resonance imaging (MRI), which can be performed either with or without computerized tomography myelography (CTM), is considered the best diagnostic technique for cervical radiculopathy (CR) [1]
This study revealed that the cross-sectional areas (CSAs) of affected nerve roots (NRs) were enlarged and that the laterality of the CSA (ΔCSA) was greater in CR patients than in control patients
The intra-observer reliability was 0.74 [95% CI 0.4–0.89], 0.71 [95% CI 0.37–0.87], 0.71 [95% CI 0.33–0.87] and 0.61 [95% CI 0.1–0.83] for the four examiners, respectively. This prospective cohort study investigated the accuracy of an ultrasonographic diagnostic approach for CR detection. This goal was accomplished by measuring the CSAs of cervical NRs in 102 patients with cervical disc herniation or osteophyte compression and the comparison of these CSAs with those of 219 normal subjects

Summary

Introduction

Magnetic resonance imaging (MRI), which can be performed either with or without computerized tomography myelography (CTM), is considered the best diagnostic technique for cervical radiculopathy (CR) [1]. Ultrasonography provides higher spatial-resolution images that are and rapidly obtained in any environment, which makes it suitable for screening. Some recent studies have used cervical nerve root (NR) ultrasonography for the ultrasonographic diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy [2, 3] and amyotrophic lateral sclerosis [4], and to measure the normal cross-sectional area (CSA) of cervical NRs [5, 6]. These studies aided in the development of cervical NR ultrasonography

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