Department of Endocrinology and Metabolism, Başkent University, Ankara, Turkey.
Department of Radiology, Başkent University, Ankara, Turkey.
Exp Clin Endocrinol Diabetes. 2021 Feb;129(2):99-103. doi: 10.1055/a-0840-3292. Epub 2019 Feb 20.
We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy.
According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness.
Achilles tendon thicknesses were similar between groups (p=0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p=0.01; group II vs control p=0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p=0.993). Shear Wave Velocity was significantly lower in group I than group IIand control group (p<0.001).
Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.
本研究旨在评估患有和不患有糖尿病周围神经病变的患者的跟腱的声辐射力脉冲弹性成像特征。
根据是否存在周围神经病变,将 45 名 2 型糖尿病患者分为 2 组。存在周围神经病变的患者被定义为组 I(22 例),不存在周围神经病变的患者被定义为组 II(23 例)。选择 30 名年龄、性别和体重指数匹配的健康个体作为对照组。所有参与者均进行超声和声辐射力脉冲弹性成像检查,以评估跟腱厚度和硬度。
组间跟腱厚度无差异(p=0.991)。两组患者的跟腱厚度均明显高于对照组(组 I 与对照组比较,p=0.01;组 II 与对照组比较,p=0.006)。对照组和组 II 的跟腱硬度值相似(p=0.993)。组 I 的剪切波速度明显低于组 II 和对照组(p<0.001)。
患有周围神经病变的糖尿病患者的跟腱更厚、更软,而无周围神经病变的糖尿病患者的跟腱弹性与健康对照组相似。跟腱的软化可能是糖尿病足的早期征象,并提示患者存在糖尿病足的风险。