High-resolution ultrasonography of the sural nerve in diabetic peripheral neuropathy.

To study the cross-sectional area, the maximum thickness of the nerve fascicle and the thickness/width ratio of the sural nerve in patients with diabetes mellitus and non-diabetic subjects using high-resolution ultrasonography and to correlate the results with nerve conduction studies. This prospective study was conducted among 60 patients divided into two groups: A and B. Group A consisted of 30 patients >18 years of age with a history of type 2 diabetes mellitus, and Group B consisted of 30 non-diabetic patients >18 years of age. High-resolution ultrasonography was performed using a linear transducer with the frequency of 5-18 MHz in all the patients in the prone position with the transducer placed in a transverse position at the junction of the middle and lower thirds of the calf. Nerve conduction studies were performed using Aleron 201 (RMS) in all the patients. As compared to the control group, the sural nerve in the diabetic group showed increased cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio ( <0.05). Nerve conduction studies showed decreased amplitude, increased latency and decreased velocity in the cases as compared to controls ( <0.05). The cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio showed statistical significance when compared with amplitude, latency and velocity in the cases as well as controls ( <0.001). This study suggests that high-frequency ultrasound of the sural nerve is a useful tool for evaluating changes typical of peripheral neuropathy in patients with diabetes mellitus. To study the cross-sectional area, the maximum thickness of the nerve fascicle and the thickness/width ratio of the sural nerve in patients with diabetes mellitus and non-diabetic subjects using high-resolution ultrasonography and to correlate the results with nerve conduction studies. This prospective study was conducted among 60 patients divided into two groups: A and B. Group A consisted of 30 patients >18 years of age with a history of type 2 diabetes mellitus, and Group B consisted of 30 non-diabetic patients >18 years of age. High-resolution ultrasonography was performed using a linear transducer with the frequency of 5–18 MHz in all the patients in the prone position with the transducer placed in a transverse position at the junction of the middle and lower thirds of the calf. Nerve conduction studies were performed using Aleron 201 (RMS) in all the patients. As compared to the control group, the sural nerve in the diabetic group showed increased cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio ( <0.05). Nerve conduction studies showed decreased amplitude, increased latency and decreased velocity in the cases as compared to controls ( <0.05). The cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio showed statistical significance when compared with amplitude, latency and velocity in the cases as well as controls ( <0.001). This study suggests that high-frequency ultrasound of the sural nerve is a useful tool for evaluating changes typical of peripheral neuropathy in patients with diabetes mellitus.