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Published in: European Radiology 12/2018

Open Access 01-12-2018 | Neuro

Shear-wave elastography: a new potential method to diagnose ulnar neuropathy at the elbow

Authors: Łukasz Paluch, Bartłomiej Noszczyk, Żaneta Nitek, Jerzy Walecki, Katarzyna Osiak, Piotr Pietruski

Published in: European Radiology | Issue 12/2018

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Abstract

Objectives

The primary aim of this study was to verify if shear-wave elastography (SWE) can be used to diagnose ulnar neuropathy at the elbow (UNE). The secondary objective was to compare the cross-sectional areas (CSA) of the ulnar nerve in the cubital tunnel and to determine a cut-off value for this parameter accurately identifying persons with UNE.

Methods

The study included 34 patients with UNE (mean age, 59.35 years) and 38 healthy controls (mean age, 57.42 years). Each participant was subjected to SWE of the ulnar nerve at three levels: in the cubital tunnel (CT) and at the distal arm (DA) and mid-arm (MA). The CSA of the ulnar nerve in the cubital tunnel was estimated by means of ultrasonographic imaging.

Results

Patients with UNE presented with significantly greater ulnar nerve stiffness in the cubital tunnel than the controls (mean, 96.38 kPa vs. 33.08 kPa, p < 0.001). Ulnar nerve stiffness of 61 kPa, CT to DA stiffness ratio equal 1.68, and CT to MA stiffness ratio of 1.75 provided 100% specificity, sensitivity, positive and negative predictive value in the detection of UNE. Mean CSA of the ulnar nerve in the cubital tunnel turned out to be significantly larger in patients with UNE than in healthy controls (p < 0.001). A weak positive correlation was found in the UNE group between the ulnar nerve CSA and stiffness (R = 0.31, p = 0.008).

Conclusions

SWE seems to be a promising, reliable and simple quantitative adjunct test to support the diagnosis of UNE.

Key Points

SWE enables reliable detection of cubital tunnel syndrome
Significant increase of entrapped ulnar nerve stiffness is observed in UNE
SWE is a perspective screening tool for early detection of compressive neuropathies
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Metadata
Title
Shear-wave elastography: a new potential method to diagnose ulnar neuropathy at the elbow
Authors
Łukasz Paluch
Bartłomiej Noszczyk
Żaneta Nitek
Jerzy Walecki
Katarzyna Osiak
Piotr Pietruski
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5517-9

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