Age-related differences in the quantitative echo texture of the median nerve.
OBJECTIVE
Currently, there are no quantitative data on the echo texture of a peripheral nerve. This study was designed to objectively compare the differences in the echo texture of the median nerve in the young and the elderly.


METHODS
The median nerves of 10 healthy young volunteers (<30 years old; group Y) and 10 elderly patients undergoing lower limb surgery (>60 years old; group E) were scanned at the mid forearm by a standardized protocol. The echo texture of a normalized median nerve image was analyzed for the echo intensity and spatial distribution of pixels. Noise in the image was reduced by using a median filter, and thresholding was performed thereafter. In the resultant binary image, the cross-sectional area, echo intensity, white area index, and black area index of the median nerve were determined by computerized texture analysis.


RESULTS
The mean cross-sectional area of the median nerve in group E was significantly smaller than that in group Y (P = .002). The mean echo intensity and white area index in group E were significantly higher than those in group Y (P= .002 and .012). The mean black area index in group E was correspondingly significantly lower than that in group Y (P = .012). In group Y, the mean white area index was significantly lower than the black area index (P = .006) but not in group E (P = .213).


CONCLUSIONS
There are significant differences in the echo texture of the median nerve between the young and the elderly. These differences may be due to age-related changes in the relative proportion of neural fascicles and connective tissue within the nerve.
Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. Dr Li is currently with the Department of Intensive Care, Minhang Hospital of Shanghai, Shanghai, China. Dr Ho is currently with the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
Xiang
X
Li
Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. Dr Li is currently with the Department of Intensive Care, Minhang Hospital of Shanghai, Shanghai, China. Dr Ho is currently with the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
Jia W
JW
Li
Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. Dr Li is currently with the Department of Intensive Care, Minhang Hospital of Shanghai, Shanghai, China. Dr Ho is currently with the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
Anthony M-H
AM
Ho
Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. Dr Li is currently with the Department of Intensive Care, Minhang Hospital of Shanghai, Shanghai, China. Dr Ho is currently with the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada karmakar@cuhk.edu.hk.
Manoj K
MK
Karmakar
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D000465:Algorithms; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000502:physiology*; D008875:Middle Aged; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
echo texture; median nerve; musculoskeletal ultrasound; sonography; texture analysis