Ultrasonography > Epub ahead of print > Article
ng ultrasound shear wave elastography to characterize peripheral nerve mechanics: a systematic review on the normative reference values in healthy individuals
Tiago Neto1 , Johanna Johannsson2 , Ricardo J. Andrade3,4,5
1Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
2Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
3Nantes University, Movement - Interactions - Performance, MIP, UR 4334, 44000, Nantes, France
4Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
5School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Australia
Corresponding Author: Ricardo J. Andrade ,Tel: +33251837241, Fax: +33251837045, Email: ricardo.andrade@univ-nantes.fr, r.andrade@griffith.edu.au
Received: November 14, 2023;  Accepted: February 14, 2024.  Published online: February 14, 2024.
ABSTRACT
Ultrasound shear wave elastography (SWE) is an emerging non-invasive imaging technique for peripheral nerve evaluation. Shear wave velocity (SWV), a surrogate measure of stiffness, holds promise as a biomarker for various peripheral nerve disorders. However, to maximize its clinical and biomechanical value, it is important to fully understand the factors that influence nerve SWV measurements. This systematic review aimed to identify the normal range of SWV for healthy sciatic and tibial nerves and to reveal the factors potentially affecting nerve SWV. An electronic search yielded 17 studies eligible for inclusion, involving 548 healthy individuals (age range, 17 to 72 years). Despite very good reliability metrics, the reported SWV values differed considerably across studies for the sciatic (1.9-9.9 m/s) and tibial (2.3-9.1 m/s) nerves. Factors such as measurement proximity to joint regions, limb postures inducing nerve axial stretching, and transducer alignment with nerve fiber orientation were associated with increased SWV. These findings suggest regional-specific nerve mechanical properties, non-linear elastic behaviour, and marked mechanical anisotropy. The impact of age and sex remains unclear and warrants further investigation. These results emphasize the importance of considering these factors when assessing and interpreting nerve SWE. While increased SWV has been linked to pathological changes affecting nerve tissue mechanics, the significant variability observed in healthy nerves highlights the need for standardized SWE assessment protocols. Developing guidelines for enhanced clinical utility and achieving a comprehensive understanding of the factors that influence nerve SWE assessments are critical in advancing the field.
Keywords: Ultrasound shear wave elastography; Ultrasonography; Sciatic neuropathy; Peripheral nervous system; Nerve biomechanics; Non-invasive mechanics; Diagnostic imaging
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