Department of Nephrology, Affiliated Hospital of Weifang Medical University, Weifang, China.
Department of Ultrasound, Affiliated Hospital of Weifang Medical University, Weifang, China.
Front Endocrinol (Lausanne). 2022 Jun 23;13:899822. doi: 10.3389/fendo.2022.899822. eCollection 2022.
To observe the feasibility of shear wave elastography (SWE) in the diagnosis of peripheral neuropathy in patients undergoing hemodialysis [chronic kidney disease stage 5 dialysis (CKD5D)].
Forty patients with CKD5D were divided into a uremic peripheral neuropathy (UPN) group (n = 25) and a non-UPN group (n = 15) according to the results of a neuro-electrophysiological examination. Sixteen healthy control subjects were also enrolled in this study. Two-dimensional ultrasound examination was conducted, and SWE was then performed to measure Young's modulus of the tibial nerve. The left and right diameters (D1), anterior and posterior diameters (D2), perimeter (C), cross-sectional area (CSA), and Young's modulus (E) were measured three times at the same non-entrapment site. The average values were recorded and calculated. The following evaluation indices were also analyzed: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC).
D1, D2, C, and CSA were not significantly different among the three groups (P > 0.05). However, the difference in the E value among the three groups was statistically significant (P < 0.05). The AUC was 0.889 based on the E value. Using a tibial nerve E value of 48.35 kPa as the cutoff value, the sensitivity, specificity, PPV, and NPV were 86.0%, 84.0%, 81.1%, and 88.1%, respectively.
SWE is useful for the diagnosis of peripheral neuropathy in patients with CKD5D. Young's modulus of 48.35 kPa for the tibial nerve is the optimal cutoff value and has the best diagnostic efficiency for peripheral neuropathy in CKD5D patients.
观察剪切波弹性成像（SWE）在诊断血液透析[慢性肾脏病 5 期透析（CKD5D）]患者周围神经病变中的可行性。
根据神经电生理检查结果，将 40 例 CKD5D 患者分为尿毒症周围神经病变（UPN）组（n=25）和非 UPN 组（n=15）。本研究还纳入了 16 名健康对照者。行二维超声检查，然后行 SWE 测量胫神经杨氏模量。在同一非卡压部位测量左、右侧直径（D1）、前、后直径（D2）、周长（C）、横截面积（CSA）和杨氏模量（E），测量 3 次，记录并计算平均值。分析以下评价指标：灵敏度、特异度、阳性预测值（PPV）、阴性预测值（NPV）和受试者工作特征曲线下面积（AUC）。
三组间 D1、D2、C 和 CSA 差异均无统计学意义（P＞0.05）。但三组间 E 值差异有统计学意义（P＜0.05）。E 值的 AUC 为 0.889。以胫神经 E 值 48.35 kPa 为截断值，灵敏度、特异度、PPV 和 NPV 分别为 86.0%、84.0%、81.1%和 88.1%。
SWE 对 CKD5D 患者周围神经病变的诊断有一定价值。胫神经杨氏模量 48.35 kPa 为最佳截断值，对 CKD5D 患者周围神经病变具有最佳诊断效率。
