Application of shear wave elastography combined with superb microvascular imaging in assessing peripheral nerves in individuals with hemiplegia

To assess alterations in peripheral nerves subsequent to a stroke by utilizing shear wave elastography (SWE) alongside microvascular imaging (MVI) technology, and to investigate the relationship between ultrasound parameters and clinical assessments. This cross-sectional investigation involved 41 individuals who experienced a stroke resulting in unilateral hemiplegia. Clinical and ultrasonographic assessments were conducted, which included the Erasmus modification of the Nottingham Sensory Assessment (Em-NSA), the Fugl-Meyer Motor Assessment (FMA), and various ultrasonographic metrics such as cross-sectional area (CSA), Young's modulus (YM), and shear wave velocity (SWV) of the median and tibial nerves, in addition to microvascular imaging of the median nerve. A comparative analysis was performed between the ultrasonographic parameters of the hemiplegic and non-hemiplegic sides. Furthermore, the correlation between ultrasonographic parameters on the hemiplegic side and clinical functionalities was examined. The CSA of the median and tibial nerves on the hemiplegic side demonstrated a marked decrease in comparison to the non-hemiplegic side ( P < 0.01). Conversely, the YM and SWV of the median and tibial nerves on the hemiplegic side were markedly elevated compared to those on the non-hemiplegic side ( P < 0.01). Additionally, microvascular perfusion in the median nerve on the hemiplegic side was considerably less than that on the contralateral side ( P < 0.05). Pearson correlation analysis demonstrated that both YM and SWV of the tibial nerve exhibited a negative correlation with Em-NSA and FMA scores ( P < 0.05). There is an augment in peripheral nerve stiffness on the hemiplegic side, accompanied by a decrease in microvascular perfusion. Moreover, YM and SWV of the tibial nerve are associated with sensory and motor deficits. The integration of SWE and MVI techniques may serve as a novel biomarker for evaluating peripheral nerve lesions following a stroke.