Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China.
Front Public Health. 2022 Jul 22;10:915883. doi: 10.3389/fpubh.2022.915883. eCollection 2022.
Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes and the strongest initiating risk factor for diabetic foot ulceration. Early diagnosis of DPN through screening measures is, therefore, of great importance for diabetic patients. Recently, shear wave elastography (SWE) has been used as a method that is complementary to neuroelectrophysiological examination in the diagnosis of DPN. We aimed to conduct a meta-analysis based on currently available data to evaluate the performance of tibial nerve stiffness on SWE for diagnosing DPN.
Both PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for studies that investigated the diagnostic performance of SWE for DPN up to March 1th, 2022. Three measures of diagnostic test performance, including the summary area under receiver operating characteristics curve (AUROC), the summary sensitivity and specificity, and the summary diagnostic odds ratios were used to assess the diagnostic accuracy of SWE. All included studies were published between 2017 and 2021.
Six eligible studies (with 170 DPN patients, 28 clinically defined DPN patients, 168 non-DPN patients, and 154 control participants) that evaluated tibial nerve stiffness were included for meta-analysis. The summary sensitivity and specificity of SWE for tibial nerve stiffness were 75% (95% confidence interval [CI]: 68-80%) and 86% (95% CI: 80-90%), respectively, and the summary AUROC was 0.84 (95% CI: 0.81-0.87), for diagnosing DPN. A subgroup analysis of five two-dimensional SWE studies revealed similar diagnostic performance, showing the summary sensitivity and specificity of 77% (95% CI: 69-83%) and 86% (95% CI: 79-91%), respectively, and a summary AUROC value of 0.86 (95% CI: 0.83-0.89).
SWE is found to have good diagnostic accuracy for detecting DPN and has considerable potential as an important and noninvasive adjunctive tool in the management of patients with DPN.
糖尿病周围神经病变（DPN）是糖尿病最常见的慢性并发症之一，也是糖尿病足溃疡发生的最强启动风险因素。因此，通过筛查措施早期诊断 DPN 对糖尿病患者非常重要。最近，剪切波弹性成像（SWE）已被用作神经电生理检查的补充方法，用于诊断 DPN。我们旨在根据现有数据进行荟萃分析，以评估胫骨神经硬度在 SWE 诊断 DPN 中的性能。
检索了截至 2022 年 3 月 1 日，关于 SWE 诊断 DPN 的研究的 PubMed、EMBASE、Cochrane 图书馆和 Web of Science。使用包括综合受试者工作特征曲线下面积（AUROC）、综合敏感性和特异性以及综合诊断优势比在内的三种诊断测试性能指标来评估 SWE 的诊断准确性。所有纳入的研究均发表于 2017 年至 2021 年之间。
纳入了 6 项符合条件的研究（共 170 例 DPN 患者、28 例临床确诊的 DPN 患者、168 例非 DPN 患者和 154 名对照参与者），对胫骨神经硬度进行了荟萃分析。SWE 诊断胫骨神经硬度的综合敏感性和特异性分别为 75%（95%置信区间 [CI]：68-80%）和 86%（95% CI：80-90%），综合 AUROC 为 0.84（95% CI：0.81-0.87），用于诊断 DPN。五项二维 SWE 研究的亚组分析显示出相似的诊断性能，综合敏感性和特异性分别为 77%（95% CI：69-83%）和 86%（95% CI：79-91%），综合 AUROC 值为 0.86（95% CI：0.83-0.89）。
SWE 被发现对 DPN 的检测具有良好的诊断准确性，并且作为 DPN 患者管理的一种重要且非侵入性的辅助工具具有很大的潜力。
