title: Utility of maximum perfusion intensity as an ultrasonographic marker of intraneural blood flow.
abstract: We quantified intraneural blood flow (INBF) using perfusion measurement software (PixelFlux), and compared it with the qualitative method of counting blood vessels (vessel score) in a cohort of carpal tunnel syndrome (CTS) patients.
  
  
  
  Forty-seven patients (67 wrists) with a clinical and electrophysiological diagnosis of CTS, and 20 healthy controls (40 wrists) were enrolled. Median nerve ultrasound (US) was performed at the carpal tunnel inlet to measure the cross-sectional area (CSA) and vessel score. Power Doppler sonograms from nerves with detectable INBF were processed with PixelFlux to obtain the maximum perfusion intensity (MPI).
  
  
  
  Forty-nine percent of CTS patients had detectable INBF compared with none in the control group (P < 0.0001). MPI correlated significantly with vessel score (r = 0.945, P < 0.0001), CSA (r = 0.613, P < 0.0001), and electrophysiological severity (r = 0.440, P < 0.0001). MPI had higher intra- or interobserver reliability compared with vessel score (0.95 vs. 0.47).
  
  
  
  MPI is a better method for quantification of INBF. Muscle Nerve, 2016 Muscle Nerve 55: 77-83, 2017.
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Adeniyi A
authors.initials: AA
authors.lastname: Borire
authors.affiliation: St. Elisabeth Ziekenhuis, Tilburg, The Netherlands.
authors.forename: Leo H
authors.initials: LH
authors.lastname: Visser
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy.|Don Gnocchi Foundation, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.|Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: James G
authors.initials: JG
authors.lastname: Colebatch
authors.affiliation: Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.|Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Huynh
authors.affiliation: Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.|St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Neil G
authors.identifier: 0000-0003-1784-8238
authors.initials: NG
authors.lastname: Simon
authors.affiliation: Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.|Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: Arun V
authors.initials: AV
authors.lastname: Krishnan
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D018615:Ultrasonography, Doppler, Color; D014953:Wrist / Q000294:innervation*
keywords: carpal tunnel syndrome; cross-sectional area; intraneural blood flow; maximum perfusion intensity; ultrasound