Introduction to High-Resolution Sonography of the Peripheral Nervous System: General Considerations and Examination Technique

Abstract

Sonography of the peripheral nerve is not essentially new. As early as 1988, Bruno Fornage reported on the feasibility of peripheral nerve imaging (Fornage 1988). The progress of nerve sonography in the subsequent years, however, was slow, and this was mainly due to the fact that nerves are small structures and were not easy to approach with the then available technique. The lacking of high-resolution transducers was the main problem and therefore it took until the late 1990s and the first years of the new millennium for sonography of the peripheral nerve to experience a real boost, which still continues. While in the early era of peripheral nerve sonography actually only freaky guys were focusing on the then exotic area of nerve imaging – there were only very few groups worldwide really devoted to nerve sonography, such as the group around Carlo Martinoli and Stefano Bianchi in Genova, Italy, Leo Visser and Roy Beekman in the Netherlands, and our group in Innsbruck, Austria – meanwhile we experience a rising interest in peripheral nerve sonography from radiologists, neurologists, and anesthesiologists alike. This explosion of nerve sonography is also due to the fact that the unexpected technical progress of ultrasound scanners, transducers, and software development is amazing. Again, peripheral nerves are small and topographically complex structures and therefore a certain arsenal of tools is important to achieve constant high quality in diagnostic and interventional nerve ultrasound.