Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Jai Prakash Hospital, New Delhi, India.
Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Jai Prakash Hospital, New Delhi, India.
Ultrasound Med Biol. 2020 Nov;46(11):2989-2997. doi: 10.1016/j.ultrasmedbio.2020.07.023. Epub 2020 Aug 18.
Diabetic foot is one of the dreaded complications of diabetes mellitus (DM). Alterations of the Achilles tendon (AT) may contribute to development of foot ulcers in diabetic patients. We evaluated the sonoelastographic abnormalities of the AT in 61 healthy volunteers and 81 patients with type 2 DM. The patients were further divided into those with and without peripheral neuropathy (PN). The AT thickness was measured in the proximal, middle and distal portions. Alterations in echo pattern were noted. The patients were found to have thicker tendons than the healthy volunteers (p < 0.01). Alterations in the echo pattern of the AT were more common in patients compared with healthy volunteers (p < 0.01). The shear wave velocity in the distal one-third of the AT was measured using shear wave elasticity imaging. Mean shear wave velocity values obtained were lower in patients compared with healthy volunteers (p < 0.001). No significant difference was found in the sonoelastographic findings of the AT in patients with and without PN. We conclude that there is softening, thickening and alterations in echo pattern of the AT in the form of hypoechogenicity, loss of fibrillar pattern and calcification at insertion in patients with type 2 DM, and these alterations could occur independent of onset of PN.
糖尿病足是糖尿病（DM）的可怕并发症之一。跟腱（AT）的改变可能导致糖尿病患者足部溃疡的发生。我们评估了 61 名健康志愿者和 81 名 2 型糖尿病患者的跟腱的超声弹性成像异常。这些患者进一步分为有和没有周围神经病变（PN）的患者。测量了跟腱近端、中段和远端的厚度。注意到回声模式的改变。与健康志愿者相比，患者的跟腱更厚（p<0.01）。与健康志愿者相比，患者的跟腱回声模式改变更为常见（p<0.01）。使用剪切波弹性成像测量了跟腱远端三分之一的剪切波速度。与健康志愿者相比，患者的平均剪切波速度值较低（p<0.001）。有和没有 PN 的患者的跟腱超声弹性成像结果无显著差异。我们得出结论，2 型糖尿病患者的跟腱存在软化、增厚和回声模式改变，表现为低回声、纤维结构丧失和附着处钙化，这些改变可能独立于 PN 的发生。
