Ultrasonography Lower Extremity Nerve Cross-sectional Area Reference Values including Demographic and Electrophysiological Relationships in Healthy Thai Adults

Chapa Puprasert; Siriwadee Ngernprasertsiri; Pariya Wimonwattrawatee

Authors

Chapa Puprasert Department of Physical Medicine and Rehabilitation, Lerdsin Hospital, Bangkok, Thailand
Siriwadee Ngernprasertsiri Department of Physical Medicine and Rehabilitation, Lerdsin Hospital, Bangkok, Thailand
Pariya Wimonwattrawatee Department of Physical Medicine and Rehabilitation, Lerdsin Hospital, Bangkok, Thailand https://orcid.org/0000-0003-3261-5432

Keywords:

cross-sectional area, ultrasonography, peripheral nerves, electrodiagnosis

Abstract

Objectives: To establish the average values of cross-sectional area (CSA) in the sural, fibular, and tibial nerves by ultrasonography and to investigate correlations with demographic data and nerve conduction studies (NCS)

Study design: A cross-sectional study

Setting: Lerdsin Hospital, Bangkok, Thailand

Subjects: Healthy Thai adults aged 19-80 years

Methods: Ninety participants were recruited and their CSA was measured at seven sites within the three nerves of the lower extremities. The NCS was performed and the mean was calculated for the values at each site. Demographic data or NCS para-meters were identified as correlations with the CSA.

Results: The mean and standard deviation values of the CSA (mm²) were: (1) sural: 2.4 (0.5), (2) fibular nerve - ankle 1.6 (0.5), fibular neck (FN) 8.3 (1.5), fibular head (FH) 9.5 (1.7), popliteal fossa (PF) 12.5 (1.5), (3) tibial nerve - ankle 11.5 (2.5), PF 16.4 (2.9), (4) the FH/PF and FH/FN ratios were 1.1 (0.2), and 1.2 (0.2). The CSAs of the sural (p = 0.048), fibular at FN (p = 0.025), fibular at PF (p = 0.043), and tibial at PF (p = 0.043) nerves were significantly greater in male than those in female. The CSA was statistically correlated with age, weight, and body mass index in the sural nerve, several sites of the fibular nerve, and the tibial nerve at the ankle. Height was associated with the CSA of the tibial nerve at the ankle (r = 0.209, p = 0.048). The CSA of the tibial nerve at PF was statistically significantly correlated with the proximal amplitude of the tibial motor NCS (r = -0.233, p = 0.027).

Conclusions: Establishing nerve CSA particular to the Thai population may offer normative values and differentiate aberrant neural structures. Some demographic characteristics and NCS can have an impact on the CSA.

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