PT  - JOURNAL ARTICLE
AU  - Telleman, Johan A.
AU  - Herraets, Ingrid J.T.
AU  - Goedee, H. Stephan
AU  - Verhamme, Camiel
AU  - Nikolakopoulos, Stavros
AU  - van Asseldonk, Jan-Thies H.
AU  - van der Pol, W. Ludo
AU  - van den Berg, Leonard H.
AU  - Visser, Leo H.
TI  - Nerve ultrasound
AID  - 10.1212/WNL.0000000000006856
DP  - 2018 Dec 28
TA  - Neurology
PG  - 10.1212/WNL.0000000000006856
4099  - http://n.neurology.org/content/early/2018/12/28/WNL.0000000000006856.short
4100  - http://n.neurology.org/content/early/2018/12/28/WNL.0000000000006856.full
AB  - Objective To determine interobserver variability of nerve ultrasound in peripheral neuropathy in a prospective, systematic, multicenter study.Methods We enrolled 20 patients with an acquired chronic demyelinating or axonal polyneuropathy and 10 healthy controls in 3 different centers. All participants underwent an extensive nerve ultrasound protocol, including cross-sectional area measurements of median, ulnar, fibular, tibial, and sural nerves, and brachial plexus. Real-time image acquisition was performed blind by a local and a visiting investigator (reference). Five patients were investigated using different types of sonographic devices. Intraclass correlation coefficients were calculated, and a random-effects model was fitted to identify factors with significant effect on interobserver variability.Results Systematic differences between measurements made by different investigators were small (mean difference 0.11 mm2 [95% confidence interval 0.00–0.23 mm2]). Intraclass correlation coefficients were generally higher in arm nerves (0.48–0.96) than leg nerves (0.46–0.61). The hospital site and sonographic device did not contribute significantly to interobserver variability in the random-effects model.Conclusions Interobserver variability of nerve ultrasound in peripheral neuropathy is generally limited, especially in arm nerves. Different devices and a multicenter setting have no effect on interobserver variability. Therefore, nerve ultrasound is a reproducible tool for diagnostics in routine clinical practice and (multicenter) research.