Application and Value of Limbs Peripheral Nerve Ultrasound in Guillain-Barre Syndrome.

Abstract

Background: At present, some Guillain-Barre syndrome (GBS) patients have a relatively poor prognosis due to the lack of timely diagnosis, and the risk of death is difficult to reduce. At present, the level of clinical diagnosis of GBS is not ideal, and the time of clinical examination and diagnosis is relatively long. How to improve the level of clinical diagnosis, clinical treatment and prognosis of GBS has always been the focus of clinical research of GBS. This study mainly analyzes the application efficacy of limb peripheral nerve ultrasound in the diagnosis, classification and disease assessment of GBS, hoping to supplement the application research of limb peripheral nerve ultrasound in the diagnosis of GBS and provide some reference for the development of clinical diagnosis of GBS.

Objective: To explore the application and value of limb peripheral nerve ultrasound in Guillain-Barre syndrome (GBS).

Methods: In this case-control study, 35 GBS patients (GBS group) and 20 healthy volunteers (normal group) were enrolled, the ultrasound features of GBS, NCSA dimensions of limbs, NCSA sizes of limbs in patients with different types of GBS, and NCSA sizes of vagus nerves in patients with different conditions of GBS were clinically detected and collected.Pearson correlation coefficient was used to evaluate the correlation between limb nerve cross-sectional areas (NCSAs) and nerve electrophysiology indexes in GBS patients. The receiver operating characteristic curve (ROC) was adopted to analyze the value of limb NCSAs for diagnosing GBS.

Results: Compared with the normal group, NCSAs of multiple limbs neurodes in the GBS group increased significantly (P < .05). Patients with different GBS classifications had significantly different limb NCSAs in the proximal or distal nerve (P < .05). Compared with patients without autonomic nervous dysfunction, patients combined with autonomic nervous dysfunction had significantly expanded NCSA of the vagus nerve (P < .05). NCSAs of the median nerve and ulnar nerve were negatively correlated with motor nerve conduction velocity (MCV) and positively correlated with compound muscle action potential (CMAP) latency (both P < .05); NCSA of the median nerve showed a negative correlation with sensory nerve conduction velocity (SCV) (P < .05).The ROC curve showed that the auc of ncsa of median nerve (median), ulnar nerve (proximal), vagus nerve, brachial plexus, and common peroneal nerve in the diagnosis of GBS were 0.851, 0.813, 0.783, 0.774, and 0.670, respectively (P < .05), which had diagnostic efficacy. The sensitivity were 85.36%, 80.08%, 78.85%, 76.93% and 70.88%, respectively. The specificity were 68.29%, 73.65%, 78.86%, 80.29% and 83.56%, respectively.

Conclusion: Limbs peripheral nerve ultrasound can effectively assist the early diagnosis, classification, and assessment of the severity of illness of GBS, it has a good diagnostic effect on multi-limb ganglion NCSA and vagus nerve NCSA.In the future, the application of limb peripheral nerve ultrasound in the early diagnosis, classification and severity assessment of GBS can improve the efficacy of clinical diagnosis of GBS and provide a good basis for the improvement of prognosis of GBS.