Omar Alomari, Bassel Alrabadi, Tarek A Hussein, Sanaa Shtayat, Rania A Hussein, Reem Alnahdi, Ragad Tawalbeh, Mahmoud Sayed Ahmed, Anas Elgenidy
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引用次数: 0
摘要
目的:格林-巴罗综合征(GBS)是一种自身免疫性疾病,引起急性炎性多神经病变,导致肌肉无力。及时诊断对于预防呼吸衰竭和长期残疾等并发症至关重要。周围神经的超声成像,特别是评估神经横截面积(CSA),已被建议作为GBS的诊断工具。本系统综述旨在评价神经超声在诊断和监测GBS中的应用。方法:按照PRISMA指南进行系统评价,检索PubMed、Scopus、Web of Science、Cochrane Library等数据库,检索截止到2024年12月。使用超声评估GBS患者与健康对照组或其他神经病变患者的周围神经大小的研究被纳入其中。采用Review Manager 5.4软件进行统计分析。结果:在848项研究中,25项符合纳入标准,其中12项纳入meta分析。共纳入528例GBS患者。超声显示GBS患者颈、腓、正中、尺、胫神经CSA明显增高。其中,颈神经增大(MD: 1.45, P = 0.0008)和腓神经增大(MD: 2.09, P)为GBS提供了有价值的诊断信息,尤其是CSA的改变,有助于早期识别和干预。需要进一步的研究来建立一致的CSA模式并提高各种GBS亚型的诊断准确性。
Ultrasound assessment of peripheral nerve size in Guillain-Barré syndrome: A systematic review and Meta-Analysis.
Purpose: Guillain-Barré Syndrome (GBS) is an autoimmune disorder causing acute inflammatory polyneuropathy, resulting in muscle weakness. Timely diagnosis is critical to prevent complications such as respiratory failure and long-term disability. Ultrasound imaging of peripheral nerves, specifically assessing nerve cross-sectional area (CSA), has been suggested as a diagnostic tool for GBS. This systematic review aims to evaluate the utility of nerve ultrasound in diagnosing and monitoring GBS.
Methods: A systematic review was conducted following PRISMA guidelines, searching databases including PubMed, Scopus, Web of Science, and Cochrane Library up to December 2024. Studies that used ultrasound to assess peripheral nerve size in GBS patients compared to healthy controls or other neuropathy patients were included. Statistical analysis was conducted using Review Manager 5.4 software.
Results: Out of 848 studies, 25 met the inclusion criteria, with 12 included in the meta-analysis. A total of 528 patients with GBS were included. Ultrasound revealed significant increases in the CSA of cervical, peroneal, median, ulnar, and tibial nerves in GBS patients. Specifically, cervical nerve enlargement (MD: 1.45, P = 0.0008) and peroneal nerve enlargement (Mean Difference (MD): 2.09, P < 0.00001) were notable. Subgroup analysis revealed significant enlargement of the ulnar and tibial nerves across different anatomical regions.
Conclusion: Ultrasound imaging of peripheral nerves, particularly changes in CSA, provides valuable diagnostic insight for GBS, may be helpful in early recognition and intervention. Further studies are needed to establish consistent CSA patterns and improve diagnostic accuracy across various GBS subtypes.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.