{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:23:13Z","timestamp":1760059393415,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: We aimed to compare well-known ultrasound protocols for inflammatory polyneuropathies in a single cohort. Methods: High-resolution ultrasound was performed according to the Bochum ultrasound score (BUS)\/neuropathy ultrasound protocol (NUP), ultrasound pattern sum score (UPSS), and EAN\/PNS suggested protocol for patients with chronic (CIDP) and acute inflammatory polyneuropathies (AIDP), multifocal motor neuropathies (MMN) and healthy controls. The upper boundaries were adjusted according to our laboratory normative values to all above-mentioned protocols; additionally, another calculation was performed using the peripheral nerve size values officially proposed by EAN\/PNS. Results: We enrolled a total of 189 subjects (105 males and 84 females), comprising 40 patients with CIDP, 13 with MMN, 11 with AIDP, and 125 healthy controls. The mean ages were 62.49 years (range 37\u201384 years) for the CIDP patients; 55.92 years (range 32\u201371 years) for the MMN patients; 68.09 years (range 51\u201388 years) for the AIDP patients; and 49.02 years (range 25\u201380 years) for the healthy controls. Using the EAN\/PNS protocol bilaterally, 72.9% of CIDP cases were identified. When the adjusted EAN\/PNS protocol was applied, the detection rate rose to 100%, with a sensitivity of 100%. Both the adjusted BUS\/NUP and UPSS protocols demonstrated a specificity of 90% in diagnosing CIDP. EAN\/PNS protocol detected 69.23% of MMN cases measured unilaterally and had a 100% sensitivity to distinguish MMN, while the UPSS protocol had the highest specificity (96%). In AIDP cases, the adjusted EAN\/PNS protocol identified 90.90% of cases through unilateral or bilateral measurements, with sensitivity 91% and specificity 88%. Conclusions: The EAN\/PNS protocol was the most valuable in the detection of treatable states, and the BUS\/NUP, UPSS protocols were the most valuable in the differentiation of specific inflammatory polyneuropathies.<\/jats:p>","DOI":"10.3390\/diagnostics15121484","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T05:23:16Z","timestamp":1749619396000},"page":"1484","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Different Ultrasound Protocols in Patients with Inflammatory Polyneuropathies with Practical Insights"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1900-3391","authenticated-orcid":false,"given":"Evelina","family":"Grusauskiene","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agne","family":"Smigelskyte","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erisela","family":"Qerama","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Aarhus University Hospital, 8200 Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5603-2357","authenticated-orcid":false,"given":"Daiva","family":"Rastenyte","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.clinph.2017.10.028","article-title":"Ultrasound and MRI of nerves for monitoring disease activity and treatment effects in chronic dysimmune neuropathies\u2014Current concepts and future directions","volume":"129","author":"Pham","year":"2018","journal-title":"Clin. Neurophysiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.clinph.2013.07.023","article-title":"Heterogeneity of root and nerve ultrasound pattern in CIDP patients","volume":"125","author":"Padua","year":"2014","journal-title":"Clin. Neurophysiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s13311-018-0609-4","article-title":"Nerve Ultrasound Predicts Treatment Response in Chronic Inflammatory Demyelinating Polyradiculoneuropathy\u2014A Prospective Follow-Up","volume":"15","author":"Ross","year":"2018","journal-title":"Neurotherapeutics"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Erdmann, A., Motte, J., Br\u00fcnger, J., Gr\u00fcter, T., Gold, R., Pitarokoili, K., and Fisse, A.L. (2022). Nerve Echogenicity in Polyneuropathies of Various Etiologies\u2014Results of a Retrospective Semi-Automatic Analysis of High-Resolution Ultrasound Images. Diagnostics, 12.","DOI":"10.3390\/diagnostics12061341"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1007\/s00415-018-9158-3","article-title":"Nerve echogenicity and intranerve CSA variability in high-resolution nerve ultrasound (HRUS) in chronic inflammatory demyelinating polyneuropathy (CIDP)","volume":"266","author":"Fisse","year":"2019","journal-title":"J. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1212\/WNL.0000000000003483","article-title":"Diagnostic value of sonography in treatment-naive chronic inflammatory neuropathies","volume":"88","author":"Goedee","year":"2017","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1745","DOI":"10.1212\/WNL.0000000000010369","article-title":"Nerve ultrasound for diagnosing chronic inflammatory neuropathy","volume":"95","author":"Herraets","year":"2020","journal-title":"Neurology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1212\/WNL.0000000000008697","article-title":"Diagnostic accuracy of MRI and ultrasound in chronic immune-mediated neuropathies","volume":"94","author":"Oudeman","year":"2020","journal-title":"Neurology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1002\/mus.26629","article-title":"Nerve ultrasound can identify treatment-responsive chronic neuropathies without electrodiagnostic features of demyelination","volume":"60","author":"Goedee","year":"2019","journal-title":"Muscle Nerve"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1470","DOI":"10.1212\/WNL.0000000000008978","article-title":"Nerve ultrasound improves detection of treatment-responsive chronic inflammatory neuropathies","volume":"94","author":"Herraets","year":"2020","journal-title":"Neurology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1016\/j.clinph.2015.01.011","article-title":"The Ultrasound pattern sum score\u2014UPSS. A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves","volume":"126","author":"Grimm","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1111\/ene.13344","article-title":"Nerve ultrasound as follow-up tool in treated multifocal motor neuropathy","volume":"24","author":"Rattay","year":"2017","journal-title":"Eur. J. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3556","DOI":"10.1111\/ene.14959","article-title":"European Academy of Neurology\/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision","volume":"28","author":"Hadden","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/jns.12594","article-title":"European Academy of Neurology\/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain-Barr\u00e9 syndrome","volume":"28","author":"Hadden","year":"2023","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1007\/s13311-019-00716-5","article-title":"Differentiation Between Guillain\u2013Barr\u00e9 Syndrome and Acute-Onset Chronic Inflammatory Demyelinating Polyradiculoneuritis\u2014A Prospective Follow-up Study Using Ultrasound and Neurophysiological Measurements","volume":"16","author":"Grimm","year":"2019","journal-title":"Neurotherapeutics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00415-016-8305-y","article-title":"Peripheral nerve ultrasound scoring systems: Benchmarking and comparative analysis","volume":"264","author":"Grimm","year":"2017","journal-title":"J. Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/mus.24484","article-title":"Bochum ultrasound score versus clinical and electrophysiological parameters in distinguishing acute-onset chronic from acute inflammatory demyelinating polyneuropathy","volume":"51","author":"Kerasnoudis","year":"2015","journal-title":"Muscle Nerve"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1002\/mus.25138","article-title":"Nerve ultrasound protocol in differentiating chronic immune-mediated neuropathies","volume":"54","author":"Kerasnoudis","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.clinph.2018.03.036","article-title":"Nerve ultrasound normal values\u2014Readjustment of the ultrasound pattern sum score UPSS","volume":"129","author":"Grimm","year":"2018","journal-title":"Clin. Neurophysiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kramer, M., Grimm, A., Winter, N., D\u00f6rner, M., Grundmann-Hauser, K., Stahl, J.H., Wittlinger, J., Kegele, J., Kronlage, C., and Willikens, S. (2021). Nerve Ultrasound as Helpful Tool in Polyneuropathies. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020211"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1007\/s00415-013-7123-8","article-title":"Ultrasound of inherited vs. acquired demyelinating polyneuropathies","volume":"260","author":"Zaidman","year":"2013","journal-title":"J. Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1111\/ene.13380","article-title":"A comparative study of brachial plexus sonography and magnetic resonance imaging in chronic inflammatory demyelinating neuropathy and multifocal motor neuropathy","volume":"24","author":"Goedee","year":"2017","journal-title":"Eur. J. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Grusauskiene, E., Smigelskyte, A., Qerama, E., and Rastenyte, D. (2024). Cross-Sectional Area and Echogenicity Reference Values for Sonography of Peripheral Nerves in the Lithuanian Population. Diagnostics, 14.","DOI":"10.3390\/diagnostics14131373"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1002\/ana.410270707","article-title":"Assessment of current diagnostic criteria for Guillain-Barr\u00e9 syndrome","volume":"27","author":"Asbury","year":"1990","journal-title":"Ann. Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"(2010). European Federation of Neurological Societies\/Peripheral Nerve Society Guideline on management of multifocal motor neuropathy. Report of a Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society\u2014First revision. J. Peripher. Nerv. Syst., 15, 295\u2013301.","DOI":"10.1111\/j.1529-8027.2010.00290.x"},{"key":"ref_26","unstructured":"Dancey, C.P., and Reidy, J. (2007). Statistics Without Maths for Psychology, Pearson Education."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Grimm, A.S., Schubert, C., Grimm, A., Stahl, J.H., K\u00fcpper, H., Horber, V., Kegele, J., Willikens, S., Wittlinger, J., and Serna-Higuita, L. (2020). Normative Observational Nerve Ultrasound Values in School-Age Children and Adolescents and Their Application to Hereditary Neuropathies. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.00303"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1002\/mus.26029","article-title":"Nerve ultrasound in polyneuropathies","volume":"57","author":"Telleman","year":"2018","journal-title":"Muscle Nerve"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Br\u00fcnger, J., Motte, J., Gr\u00fcter, T., Mork, H., Bulut, Y., Carolus, A., Athanasopoulos, D., Yoon, M.S., Gold, R., and Pitarokoili, K. (2022). Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy from Inflammatory Polyneuropathy with Secondary Axonal Damage. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.809359"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.clinph.2019.12.404","article-title":"Nerve ultrasound reference data in children from two to seven years","volume":"131","author":"Schubert","year":"2020","journal-title":"Clin. Neurophysiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/jns.12091","article-title":"Ultrasonography of the peripheral nervous system in the early stage of Guillain-Barr\u00e9 syndrome","volume":"19","author":"Grimm","year":"2014","journal-title":"J. Peripher. Nerv. Syst."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/12\/1484\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:49:53Z","timestamp":1760032193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/12\/1484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["diagnostics15121484"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15121484","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,6,11]]}}}