Use of Contrast-enhanced Sonography to Investigate Intraneural Vascularity in a Cohort of Macaca Fascicularis with Suspected Median Mononeuropathy

Overview

Journal J Ultrasound Med

Date 2013 Dec 28

PMID 24371104

Citations 3

Authors

Kevin D Evans

Kevin R Volz

Rachel L Pargeon

Larry T Fout

John Buford

Shawn C Roll

Affiliations

Soon will be listed here.

Abstract

Objectives: The purpose of this study was to provide clinical evidence of the use of contrast-enhanced sonography in detecting and quantifying changes in intraneural vascularity due to median mononeuropathy.

Methods: Five Macaca fascicularis monkeys were exposed to 20 weeks of repetitive work to increase their risk of developing median mononeuropathy. Contrast-enhanced sonograms were obtained in 30-second increments for 7 minutes while a contrast agent was being delivered. Data were collected immediately at the conclusion of the 20-week work exposure and then again during a recovery phase approximately 3 months after the completion of work. Quantitative analysis and trend graphs were used to analyze median nerve perfusion intensity. This study also compared the use of both manual counting of pixels and semiautomatic measurement using specialized software.

Results: Based on the average data, maximum intensity values were identified as the best indicators of nerve hyperemia. Paired t tests demonstrated significantly higher maximum intensities in the working stage for 4 of the 5 subjects (P < .01).

Conclusions: This study provides preliminary evidence that (1) in a controlled exposure model, a change in intraneural vascularity of the median nerve between working and recovery can be observed; (2) this vascular change can be measured using an objective technique that quantifies the intensity of vascularity; and (3) contrast-enhanced sonography may improve the ability to reliably capture and measure low-flow microvascularity.

Citing Articles

Assessing the Potential for Error in Investigating Intraneural Vascularity: A Need for a Standardized Imaging Protocol.

Yao B, Evans K, Roll S J Diagn Med Sonogr. 2023; 39(6):549-559.

PMID: 38074490 PMC: 10701715. DOI: 10.1177/87564793231193396.

Value of superb microvascular imaging ultrasonography in the diagnosis of carpal tunnel syndrome: Compared with color Doppler and power Doppler.

Chen J, Chen L, Wu L, Wang R, Liu J, Hu B Medicine (Baltimore). 2017; 96(21):e6862.

PMID: 28538376 PMC: 5457856. DOI: 10.1097/MD.0000000000006862.

Carpal tunnel syndrome severity staging using sonographic and clinical measures.

Roll S, Volz K, Fahy C, Evans K Muscle Nerve. 2014; 51(6):838-45.

PMID: 25287477 PMC: 4388767. DOI: 10.1002/mus.24478.

References

Mallouhi A, Pulzl P, Pultzl P, Trieb T, Piza H, Bodner G . Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography. AJR Am J Roentgenol. 2006; 186(5):1240-5. DOI: 10.2214/AJR.04.1715. View

Ghasemi-Esfe A, Khalilzadeh O, Vaziri-Bozorg S, Jajroudi M, Shakiba M, Mazloumi M . Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity: a quantitative image processing method. Radiology. 2011; 261(2):499-506. DOI: 10.1148/radiol.11110150. View

Forsberg F, Liu J, Patel M, Liu L, Lin L, Solis C . Preclinical acute toxicology study of surfactant-stabilized ultrasound contrast agents in adult rats. Int J Toxicol. 2009; 29(1):32-9. DOI: 10.1177/1091581809354342. View

Lee D, van Holsbeeck M, Janevski P, Ganos D, Ditmars D, Darian V . Diagnosis of carpal tunnel syndrome. Ultrasound versus electromyography. Radiol Clin North Am. 1999; 37(4):859-72, x. DOI: 10.1016/s0033-8389(05)70132-9. View

Evans K, Roll S, Volz K, Freimer M . Relationship between intraneural vascular flow measured with sonography and carpal tunnel syndrome diagnosis based on electrodiagnostic testing. J Ultrasound Med. 2012; 31(5):729-36. PMC: 3673781. DOI: 10.7863/jum.2012.31.5.729. View

Joy V, Therimadasamy A, Chan Y, Wilder-Smith E . Combined Doppler and B-mode sonography in carpal tunnel syndrome. J Neurol Sci. 2011; 308(1-2):16-20. DOI: 10.1016/j.jns.2011.06.042. View

Akcar N, Ozkan S, Mehmetoglu O, Calisir C, Adapinar B . Value of power Doppler and gray-scale US in the diagnosis of carpal tunnel syndrome: contribution of cross-sectional area just before the tunnel inlet as compared with the cross-sectional area at the tunnel. Korean J Radiol. 2010; 11(6):632-9. PMC: 2974225. DOI: 10.3348/kjr.2010.11.6.632. View

Ghasemi-Esfe A, Khalilzadeh O, Mazloumi M, Vaziri-Bozorg S, Niri S, Kahnouji H . Combination of high-resolution and color Doppler ultrasound in diagnosis of carpal tunnel syndrome. Acta Radiol. 2011; 52(2):191-7. DOI: 10.1258/ar.2010.100299. View

Sommerich C, Lavender S, Buford J, Banks J, Korkmaz S, Pease W . Towards development of a nonhuman primate model of carpal tunnel syndrome: performance of a voluntary, repetitive pinching task induces median mononeuropathy in Macaca fascicularis. J Orthop Res. 2007; 25(6):713-24. DOI: 10.1002/jor.20363. View

10.

Klauser A, Frauscher F, Schirmer M, Halpern E, Pallwein L, Herold M . The value of contrast-enhanced color Doppler ultrasound in the detection of vascularization of finger joints in patients with rheumatoid arthritis. Arthritis Rheum. 2002; 46(3):647-53. DOI: 10.1002/art.10136. View

11.

Rahmani M, Ghasemi Esfe A, Vaziri-Bozorg S, Bozorg S, Mazloumi M, Khalilzadeh O . The ultrasonographic correlates of carpal tunnel syndrome in patients with normal electrodiagnostic tests. Radiol Med. 2011; 116(3):489-96. DOI: 10.1007/s11547-011-0632-6. View

12.

Evans K, Volz K, Hutmire C, Roll S . Morphologic Characterization of Intraneural Flow Associated With Median Nerve Pathology. J Diagn Med Sonogr. 2013; 28(1):11-19. PMC: 3681420. DOI: 10.1177/8756479311426777. View

13.

Wieczorek A, Wozniak M, Stankiewicz A, Santoro G, Bogusiewicz M, Rechberger T . Quantitative assessment of urethral vascularity in nulliparous females using high-frequency endovaginal ultrasonography. World J Urol. 2011; 29(5):625-32. DOI: 10.1007/s00345-011-0732-x. View