title: Detection of Intraneural Median Nerve Microvascularity Using Contrast-Enhanced Sonography: A Pilot Study.
abstract: OBJECTIVE
  Demonstrating vascularity within the human median nerve may be difficult using power Doppler sonography. To this end, a pilot study documenting contrast-enhanced vascularity of the median nerve was conducted.
  
  
  METHODS
  Patients undergoing contrast-enhanced transthoracic echocardiography were recruited for this study (n = 24). During echocardiography, a simultaneous contrast-enhanced sonographic examination of the median nerve was conducted. The study and study protocol were built from preclinical evidence. Image analysis was based on the power Doppler pixel intensity within a defined region of interest to obtain quantitative data representing the average pixel intensity, maximum pixel intensity, and power Doppler pixel dot count. Semiquantitative data representing the power Doppler dot count grading were also obtained.
  
  
  RESULTS
  Spearman correlations between analytical methods showed strong positive, statistically significant (P< .05) correlations between the average pixel intensity and maximum pixel intensity and between the power Doppler dot count and dot count grading. Statistically significant increases in the average pixel intensity and power Doppler dot count were seen at all but 1 time point throughout the contrast-enhanced sonographic examination when compared to precontrast administration. Statistically significant increases in the maximum pixel intensity were seen at all but 4 time points.
  
  
  CONCLUSIONS
  These pilot results represent early evidence that contrast-enhanced sonography can be used to image median nerve vascularity. In this convenience sample, median nerve contrast-enhanced sonographic data collection was feasible, safe, and consistent.
authors.affiliation: The Ohio State University College of Medicine, Columbus Ohio USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Volz
authors.affiliation: The Ohio State University College of Medicine, Columbus Ohio USA evans.36@osu.edu.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Evans
authors.affiliation: The Ohio State University College of Medicine, Columbus Ohio USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Kanner
authors.affiliation: Department of Internal Medicine, The Ohio State University, Columbus Ohio USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dickerson
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008475:Median Nerve / Q000098:blood supply* / Q000000981:diagnostic imaging*; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010865:Pilot Projects; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: carpal tunnel syndrome; contrast-enhanced sonography; median nerve; musculoskeletal ultrasound; power Doppler sonography