Ultrasound simulation of peripheral nerves: development of a novel technology for training in regional anaesthesia

Objective Regarding education in ultrasound-guided regional anaesthesia, we aimed to develop three-dimensional ultrasound volumes (3D-UV) of peripheral nerves for ultrasound simulation. This study mainly addressed to estimate diagnostic feasibility as well as comparison of original ultrasound images with 3D-UV. Methods A free-hand recording system as part of an ultrasound simulation system ( Ultrasound simulator Reslice, Schallware GmbH, Berlin, Germany) was coupled to a high-end ultrasound device (Vivid-i, GE healthcare Ultrasound). 3D-UV were recorded as transverse parallel planes from four healthy models and positioned with an electromagnetic tracking system into a mannequin on identical anatomical sites. Using developer software, single B-Mode 3D-UV were combined into 3D-multivolumes (MV). Original short and long axis B-Mode planes were compared with reconstructed planes (reslices). Results A total of 108 3D-UV including vessels of carotid region (n = 22), and peripheral nerves of interscalene (31), axillary (28), femoral groin (8) and distal sciatic (19) were recorded. Visual presentation of reconstructed volumes of vessels and peripheral nerves revealed almost comparable quality to the original B-Mode scans of the model examination. Ultrasonographic nerve structure appearance derived from high-resolution ultrasound recordings could be preserved in reslices of 3D-UV and also in part in the long axis. Conclusions Our data provide a new proof of concept for ultrasound simulation of peripheral nerves in 3D-ultrasound multivolumes based on high-resolution ultrasound technology. It has the ability to provide pathologic findings and may serve as a powerful method for training in regional anaesthesia and critical care ultrasound.