1 |
Bedewi et al. did a case control study for determining the CSA of lower limb peripheral nerves to establish some reference values.CSA values were obtained for tibial nerve, common peroneal nerve and sural nerve(15). |
Normal reference value for the tibial nerve was 19 mm2 ± 6.9 at the popliteal fossa and 12.7 mm2 ± 4.5 at the level of the medial malleolus. The study revealed a positive correlation between CSA and weight, BMI, and age of subjects. No significant relationship was observed between CSA and height or gender. |
2. |
Fisse et al. performed a systematic review and a meta-analysis of published CSA reference values for lower extremity nerves(16). |
They calculated the mean CSA of the tibial nerve at popliteal fossa and at malleolus, which was 25.9 mm2 and 10.0 mm2, respectively. |
3. |
Qrimli et al. conducted a study in 100 healthy volunteers. Median, ulnar, fibular, tibial, sural and superficial fibular nerves were studied at predetermined sites with high-resolution US(8). |
Positive correlation was observed between the CSA of nerve and age of the subjects. However, gender and BMI had no significant relationship with the cross sectional area of nerve. CSA tends to be bilaterally symmetrical in both lower limbs. |
4. |
Study conducted by Kerasnoudis et al.(7) |
CSA reference values for peripheral nerves acquired in their study, showed a positive correlation with age, weight and sex of the subjects. However, no obvious correlation was seen with height. |
5. |
Singh et al. performed study on radial nerve(17). |
Strong correlation between the CSA of the radial nerve and height, weight, BMI was seen with no statistically significant correlation with age. Males had higher CSA values for the radial nerve than females. |
6. |
Singh et al. performed study on the sciatic nerve(18). |
Reference CSA values for the sciatic nerve were also studied by Singh et al. and the values were correlated statistically with the demographic parameters. They concluded that a positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. |
7. |
In a study by Chen et al. on sciatic nerve(5). |
CSA of sciatic nerves was measured with high resolution US in 200 subjects. The results showed that females had smaller CSA of sciatic nerves than males at the two different sites (p <0.05). |
8. |
Kowalska et al. performed a study on median, ulnar, common peroneal, digital, cutaneous nerve in the deltoid area, mental and posterior interosseous nerve in patients referred for ultrasound due to clinical suspicion of traumatic peripheral neuropathies(14). |
US findings were consistent with the clinical and surgical verification in almost 100 % of cases. |
9. |
Singh et al. performed a study on thetibial nerve in diabetic patients having diabetic peripheral neuropathy(19). |
The mean CSA along with maximum thickness of nerve fascicles of the tibial nerve in patients with diabetic peripheral neuropathy was significantly on higher side as compared with controls. Statistically significant correlation was also found with the Toronto Clinical Neuropathy Score (p <0.001). |
10. |
Study conducted by Riazi et al. in diabetic patients on peripheral nerve(20). |
Mean CSA of the posterior tibial nerve above the medial malleolus was considerably larger in the diabetic sensorineural polyneuropathy subjects compared with controls. |
11. |
Singh et al. performed a study in diabetic patients with clinically diagnosed diabetic polyneuropathy and healthy adult volunteers(3). |
The mean CSA of the medial, ulnar, common peroneal and posterior tibial nerves was measured in the two groups at identical sites. CSA was significantly higher in diabetic patients as compared to healthy volunteers. |
12. |
Afsal et al. performed a study in five patients with diabetic peripheral neuropathy(21). |
Diffuse thickening of peripheral nerves along with higher mean CSA of the median nerve and the ulnar nerve was found in patients with diabetic peripheral neuropathy when compared to controls. |
13. |
Study by Lee et al. on peripheral nerves(22). |
Concluded that ultrasonography plays a vital role in diagnosing a lesion and its location accurately in the 13 cases who were the subjects of their study. In 7 (58%) out of 12 cases, ultrasonography contributed to establishing the correct diagnosis when other imaging and electrophysiological studies were inconclusive or inadequate. |