This study aimed to compare the fascicular anatomy of upper limb nerves visualized using in situ high-resolution ultrasound (HRUS) with ex vivo imaging modalities, namely, magnetic resonance microscopy (MRM), histological cross-sections (HCS), and optical projection tomography (OPT). The median, ulnar, and superficial branch of radial nerve (n = 41) were visualized in 14 cadaveric upper limbs using 22-MHz HRUS. Subsequently, the nerves were excised, imaged with different microscopic techniques, and their morphometric properties were compared. HRUS accurately differentiated 51-74% of fascicles, while MRM detected 87-92% of fascicles when compared to the referential HCS. Among the compared modalities, HRUS demonstrated the smallest fascicular ratios and fascicular cross-sectional areas, but the largest nerve cross-sectional areas. The probability of a fascicle depicted on HRUS representing a cluster of multiple fascicles on the referential HCS increased with the fascicular size, with some differences observed between the larger median and ulnar nerves and the smaller radial nerves. Accordingly, HRUS fascicle differentiation necessitates cautious interpretation, as larger fascicles are more likely to represent clusters. Although HCS is considered the reference modality, alterations in nerve cross-sectional areas or roundness during sample processing should be acknowledged.

• MeSH
• Upper Extremity * innervation   diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Microscopy methods   MeSH
• Cadaver MeSH
• Median Nerve diagnostic imaging   MeSH
• Radial Nerve * diagnostic imaging   anatomy & histology   MeSH
• Ulnar Nerve * diagnostic imaging   anatomy & histology   MeSH
• Aged MeSH
• Ultrasonography * methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• Keywords
• extirpace,
• MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Adolescent MeSH
• Ulnar Nerve * surgery   diagnostic imaging   pathology   MeSH
• Neurosurgical Procedures methods   MeSH
• Neurofibroma * surgery   diagnostic imaging   classification   physiopathology   pathology   MeSH
• Paraneoplastic Syndromes, Nervous System classification   MeSH
• Arm pathology   MeSH
• Peripheral Nerves physiopathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

Loketní nerv spolu se středním nervem inervují volární skupinu svalů předloktí, ruku i prsty. Má větší význam pro motorickou inervaci a při jeho poruše vzniká oslabení, neobratnost prstů i ruky a v pokročilých případech atrofie svalů s rozvojem ulnární drápovité ruky. Vzhledem k délce i k exponovanému průběhu v oblasti lokte i ruky je nerv často mechanicky přetěžován i poškozován. V oblasti axily a paže se poranění nervu vyskytuje vzácně. Velmi často je loketní nerv poškozen v oblasti lokte, kde nerv probíhá v různě hlubokém loketním žlábku a pak v kubitálním tunelu. Na předloktí je chráněn vrstvou flexorů. Nerv vystupuje k povrchu na zápěstí a v dlani, kde je vystaven chronické traumatizaci. Léze loketního nervu se projeví charakteristickými poruchami hybnosti a senzitivity, a to na podkladě lokalizace i tíže léze. V diagnostice poškození nervu se používají elektrodiagnostické metody i stále více zobrazovací vyšetření (zejména ultrasonografie). Chronické přetížení s poškozením n. ulnaris v oblasti lokte je druhá nejčastější profesionální mononeuropatie. Proto byla vytvořena přesná metodika stanovení léze n. ulnaris v loketním úseku profesionálního původu. Chirurgická léčba léze loketního nervu v oblasti lokte i v oblasti ruky a zápěstí má různé přístupy a bývá ve většině případů úspěšná.

Ulnar nerve, together with median nerve, innervates the volar group of forearm muscles, hand and fingers. Ulnar nerve is more important for innervation of muscles and weakness, clumsiness of fingers and hand occure in case of the nerve lesion; ulnar claw hand developes in advanced cases. According to the length of the nerve and to the exposed course in regions of elbow and hand, the nerve is frequently overstretched and damaged. The nerve traumatization occurs only rarely in the axilla and arm regions. The ulnar nerve is very often damaged in the elbow, where the nerve is located in a differently deep ulnar nerve grove and then in the cubital tunnel. The ulnar nerve is protected in the forearm course by a layer of flexor muscles. The nerve appears more superficially at the wrist and in the palm, where the ulnar nerve is exposed to chronic traumatization. An ulnar nerve lesion manifests with characteristic weakness of movements and sensitivity disturbances with respect to localization and severity of the lesion. At present, electrodiagnostic methods are the most useful in the diagnostics of the ulnar nerve lesions but neuroimaging (especially ultrasonography) is increasingly more often indicated. Chronic overburden with a damage of the ulnar nerve in the elbow is the second most frequent occupational mononeuropathy. This is why precise methodology for determination of ulnar nerve lesions in the elbow due to occupational cause was developed. Variable approaches are used for surgical treatment of ulnar nerve lesions in the elbow or in the wrist and hand and the surgery is the appropriate and effective therapy in the majority of cases.

• MeSH
• Diagnosis, Differential MeSH
• Electrodiagnosis classification   methods   MeSH
• Electromyography methods   MeSH
• Humans MeSH
• Occupational Diseases MeSH
• Ulnar Nerve * anatomy & histology   diagnostic imaging   pathology   MeSH
• Ulnar Neuropathies diagnosis   etiology   complications   MeSH
• Ultrasonography methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Examination Questions MeSH