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2 results

  • Chapter 5 - Imaging

  • from Part I - Evaluation and Treatment of Patients with a Neuromuscular Disorder
  • Jessica E. Hoogendijk, University Medical Center Utrecht, Marianne de Visser, Amsterdam University Medical Center, Pieter A. van Doorn, Erasmus MC, University Medical Center, Rotterdam, Erik H. Niks, Leiden University Medical Center
  • Book:
    Neuromuscular Disease
    Published online:
    29 November 2024
    Print publication:
    19 December 2024, pp 42-46

  • Summary

    Magnetic resonance imaging (MRI) and ultrasound (US) of nerves and muscles are increasingly used as complementary tools in the diagnosis of neuromuscular disorders. Ultrasound has superior image resolution over MRI, a flexible field of view, and relatively low cost. US is also the preferred imaging modality when evaluating superficial structures. In contrast, MRI has the advantage of dedicated sequences with unique tissue-discriminating properties, and coverage of more deeply located structures. However, MRI requires dedicated protocols and visual assessment is limited by a high interobserver variability. US is device- and operator-dependent, and less suitable for evaluating much deeper structures. Visual assessment is, like MRI, subject to interobserver variability. Qualitative US has the ability to obtain more objective and repeatable measures.

  • The Sensitivity and Specificity of Split-Hand Index Using Muscle Sonography

  • Reuven Avidan, Yaara Fainmesser, Vivian E. Drory, Vera Bril, Alon Abraham
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 50 / Issue 2 / March 2023
    Published online by Cambridge University Press:
    22 February 2022, pp. 228-233
    • Article
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  • Background:

    The split-hand index (SHI) (first dorsal interosseous (FDI) × abductor pollicis brevis (APB)/abductor digiti minimi muscle (ADM)) has been suggested as a useful measure for amyotrophic lateral sclerosis (ALS) diagnosis, using electrophysiological and sonographic indices. In the present study, we aimed to explore the specificity of SHI derived by muscle ultrasound (MUS) for the diagnosis of ALS and spinal muscular atrophy (SMA).

    Methods:

    Healthy controls (n = 65) were prospectively recruited at the Prosserman Family Neuromuscular clinic at Toronto General Hospital, from October to December 2018. In addition, 181 patients with ALS (n = 91), SMA (n = 33), polyneuropathy (n = 35), and myopathy (n = 22) were prospectively recruited at the neuromuscular clinic at Tel Aviv Sourasky Medical Center, from December 2018 to December 2020. All subjects underwent quantitative sonographic evaluation of muscle thickness, including the right APB, FDI, and ADM muscles. Area under curve (AUC), sensitivity, and specificity were determined for differentiating between groups.

    Results:

    Although SHI showed good to excellent accuracy for differentiating each patient subgroup from controls (AUC 0.83–0.92), poorer diagnostic accuracy was shown for differentiating between different patient subgroups (AUC 0.54–0.74).

    Conclusions:

    Sonographic SHI is useful for differentiating patients from healthy controls, but might be not specific for motor neuron disease.