high-resolution sonography a new technique to detect nerve damage in leprosy高分辨率超声新技术检测麻风的神经损伤.pdfVIP

High-Resolution Sonography: A New Technique to Detect Nerve Damage in Leprosy 1 1,2 3 1 3 Suman Jain *, Leo H. Visser , T. L. N. Praveen , P. Narasimha Rao , Thummalakunta Surekha , Ramesh 1 3 1 Ellanti , Thummalakunta L. N. Abhishek , Indira Nath 1 Clinical and Epidemiology Division, Blue Peter Research Centre, LEPRA Society, Cherlapally, Hyderabad, India, 2 Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands, 3 Abhishek Institute of Imageology, Secunderabad, India Abstract Background: Leprosy is the most common treatable peripheral nerve disorder worldwide with periods of acute neuritis leading to functional impairment of limbs, ulcer formation and stigmatizing deformities. Since the hallmarks of leprosy are nerve enlargement and inflammation, we used high-resolution sonography (US) and color Doppler (CD) imaging to demonstrate nerve enlargement and inflammation. Methology/Principal Findings: We performed bilateral US of the ulnar (UN), median (MN), lateral popliteal (LP) and posterior tibial (PT) nerves in 20 leprosy patients and compared this with the clinical findings in these patients and with the sonographic findings in 30 healthy Indian controls. The nerves were significantly thicker in the leprosy patients as compared to healthy controls (p,0.0001 for each nerve). The two patients without nerve enlargements did not have a type 1 or type 2 reaction or signs of neuritis. The kappa for clinical palpation and nerve enlargement by sonography was 0.30 for all examined nerves (0.32 for UN, 0.41 for PN