Asian Journal of Medical Radiological Research ¦Volume 7 ¦ Issue 2 ¦ July-December 2019 26 Spectrum of High Resolution Ultrasonography and Color Doppler Findings in Peripheral Neuropathy B.L. Kumawat 1 , Manisha Sharma 2 , C.M. Sharma 3 , Aakanksha Agarwal 4 1 Professor, Department of Neurology, SMS Medical College and Hospital, Jaipur, Rajasthan, India-302004, 2 DM Resident, Department of Neurology, SMS Medical College and Hospital, Jaipur, Rajasthan, India-302004, 3 Senior Professor, Department of Neurology, SMS Medical College and Hospital, Jaipur, Rajasthan, India- 302004, 4 Resident, Department of Radiodiagnosis, SMS Medical College and Hospital, Jaipur, Rajasthan, India-302004. Background: Available diagnostic modalities for peripheral neuropathies e.g clinical assessment, electrodiagnostics, skin and nerve biopsy has certain limitations. The role of imaging is very limited. Purpose of this study is to evaluate findings in various peripheral neuropathies on ultrasonography and color Doppler. Subjects and Methods: Fifty adult patients of either sex with already diagnosed peripheral neuropathies were evaluated with high resolution ultrasound and color doppler of the relevant peripheral nerves and were compared with age and sex matched fifty healthy adult controls. Results: The study included patients with various peripheral neuropathies (carpal tunnel syndrome, diabetic peripheral neuropathy, leprosy, chronic inflammatory demyelinating polyradiculoneuropathy, and peripheral nerve trauma). There was a significant increase in cross sectional area and change in echogenicity of median nerve at carpal tunnel in carpal tunnel syndrome (p<0.05). Multiple nerves in diabetic peripheral neuropathy and leprosy patients showed increased cross sectional area and altered echogenicity as compared to controls (P < 0.05). Patients with CIDP showed diffusely hyperechoic peripheral nerves. Sonography in peripheral nerve trauma showed significant hyperechogenicity and increased vascularity on doppler at site of trauma with precise localization. Conclusion: High resolution ultrasonography with color doppler showed greater extent of quantitative and qualitative alterations in peripheral nerves in various peripheral neuropathies. USG has the potential to complement other diagnostic investigations such as the nerve conduction study in polyneuropathies and can objectively measure nerve damage in some focal neuropathies. It is easily available and has the potential to become the first modality for screening or evaluation of peripheral neuropathies. Keywords: Color Doppler, Peripheral Neuropathy, Ultrasonography. Corresponding Author: Dr. Manisha Sharma, DM Resident, Department of Neurology, SMS Medical College and Hospital, Jaipur, Rajasthan, India-302004 Received: June 2019 Accepted: July 2019 Introduction History, physical examination, laboratory studies, electrodiagnostic studies (EDx), CSF examination, nerve and skin biopsy are already available diagnostic modalities for evaluation of peripheral neuropathy. But these are not free of limitations. There is no reliable means of studying proximal sensory nerves. Nerve conduction study results can be normal in patients with small-fiber neuropathies. Lower extremity sensory responses can be absent in normal elderly patients which may confound the results. EDx are not substitutes for a good clinical examination and do not provide information regarding the cause of neuropathy. Nerve biopsy, skin biopsy and CSF are invasive procedures. Clinical examination may suffer because of subjective errors like examination of thickened peripheral nerves. [1] This persued us to explore other modality of diagnostic method which may complement or supplement present methods. Ultrasonography (USG) and magnetic resonance imaging (MRI) provide high-resolution assessment of peripheral nerves and permits direct assessment of pathological changes in nerve structure and/or in the adjacent tissue, as well. These enhance the information by illuminating the morphological aspects and etiology of peripheral nerve pathology. USG is more assessable, provides dynamic images, assesses long nerve segments in a short time, has easy bed-side-availability, benefit of non-invasivity, reasonably priced and has good resolution. So it is easy for use in everyday neurological practice. MRI on the other hand is appropriate for assessment of deep lying structures hindered by bone. [2] All major nerves of the extremities, e.g. the median, ulnar, radial, sciatic, tibial and peroneal nerves, in their entire course can be evaluated by USG including smaller nerves, e.g. the posterior interosseus, superficial radial nerve, saphenous, sural and superficial peroneal nerves. Spinal nerves C4-C8, the supraclavicular brachial plexus, and cranial nerves like the vagal and accessory nerves can be seen on USG. [3] There are certain limitations of ultrasonographic technique. For sonography of the peripheral nerves a high image quality and resolution are critical. For an optimal resolution ISSN (0): 2347-338X; ISSN (P): 2347-3371 Original Article Abstract