The “transparent” man: Nerve ultrasound allows the exact diagnosis and therapy of injuries to the nerves
Nerve ultrasound has rapidly developed into becoming a more precise and easily applied diagnosis tool. People suffering from injuries of peripheral nerves and require reconstructive plastic surgery often have a long history of woe and many operations behind them. Today, with nerve ultrasound, this time of woe can be extremely truncated, as the ultrasound-supported view into the neural pathways helps to take more precise and faster measures during diagnosis as well as therapy. With their research at the clinical divisions for neuro-radiology and muscular-skeletal radiology (Management of the nerve ultrasound research team: Gerd Bodner), MedUni Vienna has substantially participated in the speedy development of these new sonography methods.
As well as the illustration of frequent bottleneck syndromes of the hand, now established as standard diagnostics, such as carpal tunnel syndrome (injury of the middle arm nerve in the carpus) and the cubital tunnel syndrome (injury of the ulna nerve), the high-resolution sonography with up to 22 megahertz probes, continues to permit ever new ranges of application in nerve injuries: for example after the implantation of cruciate ligament plastics at the knee or tumour formations at sensory nerves (neuromas).
“With the aid of the new ultrasound equipment we managed to very precisely illustrate the peripheral neural pathways and examine them”, says Georg Riegler of the University Clinic for Radiology and Nuclear Medicine of MedUni Vienna on the occasion of the ECR (European Society of Radiology) from 2-6 March in Vienna, the largest European radiology congress. This allows the radiologists to precisely diagnose whether it is a matter of neural injury as well as the type or whether a tumour is causing the problems; this naturally also includes the precise location of the lesion on the nerve. Riegler: “With the aid of the sonography, we are able to see the origin of the nerve, where it goes and how it progresses. This is particularly important for preoperative diagnostics.”
In case of the therapy, this in turn means that one can accurately place the intervention: for example, it is possible to determine to the micrometre where a ganglion (neural tumour) has to be tapped in order to remove it. The same applies for radio frequency therapy, whereby high frequency electricity fields are used to destroy the pathological neural tissue with heat. “In both cases, ultrasound helps us to see precisely where we can and should place the needle”, explains Riegler.
On one hand, these improved options represent significant savings in resources and medication, but particularly reduce the patient’s time of suffering, which consequently requires them to remain in hospital for shorter periods and generally endure less surgical procedures.