Study of Normal Cross-sectional Area of Upper Limb Peripheral Nerves by High-resolution Ultrasonography
Kanchan Lata, Madhu Sharma, Vandana Verma, Samrendra Narayan, Hari Singh, Sucheta Sharma
In the present study, we have tried to establish reference value of cross-sectional area (CSA) of upper limb nerves. Three hundred normal subjects were studied and CSAs of median, radial, and ulnar nerve were measured at anatomical sites, such as median nerve at palmar aspect of wrist ventral to flexor retinaculum, ulnar nerve medialâ€“posterior aspect of medial epicondyle, and radial nerve in spiral groove of humerus bone. Earlier also Cross sectional area reference value s by HRSUS has been studied. We have correlated CSAs with age, gender, and height. Cases we studied were between the age group of 20 and 50 years, and most of them were 20 to 40 years. There were 179 males and 121 females in our study. The mean CSA of median nerve was 8.27 mm2 among males and 8.04 mm2 among females with p-value < 0.05, hence the difference between male and female is statistically significant. Mean CSA of ulnar nerve of right hand was 6.39 mm2 among males and 6.08 mm2 among females, with p-value < 0.05, hence the difference between male and female is statistically significant. The mean CSA of ulnar nerve of right hand was 6.39 mm2 among males and 6.08 mm2 among females, with p-value <0.05 and the difference between males and females is significant. Mean CSA of radial nerve of right hand was 3.76 mm2 in males and 3.86 mm2 in females and of the left hand was 3.78 mm2 in males and 3.79 mm2 in females with p-value > 0.05 mm, hence the difference between males and females is insignificant. In our study, we have found that males have significant larger values than females in upper limbs. The ulnar nerve in medial epicondyle and radial nerve in spiral groove showed decrease in diameter with increasing age. However, there is no significant correlation with height and handedness found. High-resolution ultrasonography (HRUS) is noninvasive, nonionizing, readily available modality capable of depicting real-time static and dynamic morphological information of peripheral nerves and surrounding tissues and is less costeffective, hence very useful initial diagnostic modality.
Cross-sectional area, High-resolution ultrasonography, Nerve fascicles, Statistically significant