The Influence of Evaluator Experience, Dynamic Versus Static Ultrasound Image Interpretation, and Probe Frequency on Fascicle Differentiation

IF 2.4 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2026-09-01 Epub Date: 2026-05-25 DOI:10.1016/j.jhsa.2026.04.004

Luka Pušnik MD, Natalie Winter MD, Maks Matej Cuzak, Igor Serša PhD, Nejc Umek MD, PhD, Žiga Snoj MD, PhD, Gregor Omejec PT, PhD

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引用次数: 0

Abstract

Purpose

To determine the influence of evaluator experience, dynamic versus static ultrasound (US) image interpretation, and probe frequency on fascicle differentiation.

Methods

Evaluator experience and dynamic versus static US image interpretation were assessed on 12 cadaveric forearms. Median nerves were scanned using a 23-MHz US probe, followed by nerve excision and high-field magnetic resonance imaging (MRI) at 9.4-T. Five independent evaluators with different experience levels delineated fascicles twice, using static and dynamic US images. Delineations were compared with high-field MRI. The influence of probe frequency was evaluated on 12 median nerves of healthy volunteers. Median nerves at wrist were scanned using 14-, 18-, 24-, and 70-MHz US probes. Images were cross-referenced, and fascicle counts were compared relative to the highest-frequency probe.

Results

Dynamic imaging improved fascicle differentiation by 27.6% to 51.2% compared to static (P < .001), with a greater benefit for less experienced evaluators. The most experienced evaluator identified on average 62.3% more fascicles in dynamic assessment compared to the least experienced. The 70-MHz probe showed the highest mean fascicle count (27.6 ± 3.7), while 24-, 18-, and 14-MHz probes differentiated 26%, 46%, and 63% fewer fascicles, respectively (P <. 0001).

Conclusions

Fascicle differentiation improves significantly with evaluator experience, using dynamic US image interpretation, and higher probe frequency. These findings support the clinical utility of ultrahigh-frequency US for detailed evaluation of superficial nerves.

Clinical relevance

Experience and dynamic image interpretation are important for reliable fascicle recognition and to minimize misinterpretation. Ultrahigh-frequency US probes substantially improve fascicle differentiation, but their limited penetration requires careful selection of probe frequency based on nerve depth.

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评估者经验、动态与静态超声图像解读及探针频率对神经束分化的影响。

目的：探讨评估者经验、动态与静态超声（US）图像解读及探头频率对肌束分化的影响。方法：对12具尸体前臂进行评估者经验和动态与静态US图像判读。采用23 mhz US探针扫描正中神经，然后行神经切除和9.4 t高场磁共振成像（MRI）。5名具有不同经验水平的独立评估人员分别使用静态和动态图像描绘了两次肌束。与高场MRI进行比较。研究了探针频率对12条健康志愿者正中神经的影响。使用14、18、24和70 mhz US探针扫描手腕正中神经。图像被交叉引用，束计数相对于最高频率的探针进行比较。结果：与静态成像相比，动态成像可使肌束分化提高27.6%至51.2% (P < 0.001)，对经验不足的评估人员有更大的益处。与经验最少的评估者相比，最有经验的评估者在动态评估中平均多识别出62.3%的肌束。70 mhz探针显示最高的平均束束计数（27.6±3.7），而24、18和14 mhz探针分化束束分别减少26%、46%和63% (P结论：评估者经验显著改善束束分化，使用动态美国图像解释，更高的探针频率。这些发现支持了超高频超声对浅表神经详细评估的临床应用。临床相关性：经验和动态图像解释对于可靠的神经束识别和减少误解是重要的。超高频超声探头可显著改善神经束分化，但其穿刺力有限，需要根据神经深度仔细选择探头频率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.