Nerve ultrasound: A reproducible diagnostic tool in peripheral neuropathy. (29th January 2019)

• Record Type: Journal Article
• Authors: Telleman, Johan A.; Herraets, Ingrid J.T.; Goedee, H. Stephan; Verhamme, Camiel; Nikolakopoulos, Stavros; van Asseldonk, Jan-Thies H.; van der Pol, W. Ludo; van den Berg, Leonard H.; Visser, Leo H.
• Is Part Of: Neurology. Volume 92:Number 5(2019)
• Publication Date: 2019-01-29
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000006856
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To determine interobserver variability of nerve ultrasound in peripheral neuropathy in a prospective, systematic, multicenter study. Methods: We enrolled 20 patients with an acquired chronic demyelinating or axonal polyneuropathy and 10 healthy controls in 3 different centers. All participants underwent an extensive nerve ultrasound protocol, including cross-sectional area measurements of median, ulnar, fibular, tibial, and sural nerves, and brachial plexus. Real-time image acquisition was performed blind by a local and a visiting investigator (reference). Five patients were investigated using different types of sonographic devices. Intraclass correlation coefficients were calculated, and a random-effects model was fitted to identify factors with significant effect on interobserver variability. Results: Systematic differences between measurements made by different investigators were small (mean difference 0.11 mm 2 [95% confidence interval 0.00–0.23 mm 2 ]). Intraclass correlation coefficients were generally higher in arm nerves (0.48–0.96) than leg nerves (0.46–0.61). The hospital site and sonographic device did not contribute significantly to interobserver variability in the random-effects model. Conclusions: Interobserver variability of nerve ultrasound in peripheral neuropathy is generally limited, especially in arm nerves. Different devices and a multicenter setting have no effect on interobserver variability. Therefore, nerve ultrasound is a reproducible tool for diagnostics in routine clinical practice and (multicenter) research.