Jiang Wenting, Liao Liping, Lai Zhenhan, Li Kaiwu, Luo Weiwen, Shen Haolin
Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University Zhangzhou 363000, Fujian, China.
Science and Education Section, Zhangzhou Affiliated Hospital of Fujian Medical University Zhangzhou 363000, Fujian, China.
Am J Transl Res. 2024 Jul 15;16(7):3280-3288. doi: 10.62347/WNSL1894. eCollection 2024.
To explore the clinical utility of ultrasound in evaluating and grading neuromuscular diseases in the lower extremities of patients with diabetes mellitus.
A total of 126 inpatients from the Department of Diabetes at Zhangzhou Affiliated Hospital of Fujian Medical University, China, were recruited from June 2020 to December 2022. The cohort included 69 patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN group) and 57 patients with T2DM but without DPN (non-DPN group). Additionally, 80 healthy controls were included. High-frequency ultrasound was used to scan the common peroneal, sural, and tibial nerves, measuring their transverse (D1) and anteroposterior (D2) diameters, and calculating the cross-sectional area (CSA). Changes in the internal echo of the extensor digitorum brevis (EDB) muscle, including maximum thickness and CSA, were also recorded. The DPN group was further subdivided based on disease duration to assess ultrasonic changes over time and the statistical significance of these variations.
Ultrasonic changes such as uneven internal echo reduction, ill-defined epineurial boundaries, and obscured cribriform structures were most prevalent in the DPN group. Significant differences in ultrasound parameters (D1, D2, CSA) were observed among the groups (all P<0.05), with the most pronounced changes in the DPN group. In patients with a disease duration of over 15 years, a significant increase in CSA of lower extremity nerves and a decrease in CSA of the EDB were noted compared to those in the 5-10 years subgroup (19.89±0.98 vs 19.00±0.94; 5.25±0.74 vs 5.93±0.94; all P<0.05).
High-frequency ultrasound provides a valuable imaging basis for diagnosing and monitoring DPN, demonstrating significant changes in nerve and muscle parameters among diabetic patients.
探讨超声在评估糖尿病患者下肢神经肌肉疾病及分级中的临床应用价值。
选取2020年6月至2022年12月福建医科大学附属漳州医院糖尿病科的126例住院患者。该队列包括69例2型糖尿病（T2DM）合并糖尿病周围神经病变患者（DPN组）和57例T2DM但无DPN患者（非DPN组）。另外，纳入80例健康对照者。采用高频超声扫描腓总神经、腓肠神经和胫神经，测量其横径（D1）和前后径（D2），并计算横截面积（CSA）。记录趾短伸肌（EDB）肌肉内部回声的变化，包括最大厚度和CSA。DPN组根据病程进一步细分，以评估超声随时间的变化以及这些变化的统计学意义。
DPN组最常见的超声改变为内部回声不均匀减低、神经外膜边界不清和筛状结构模糊。各组间超声参数（D1、D2、CSA）差异有统计学意义（均P<0.05），DPN组变化最为明显。与病程5 - 10年亚组相比，病程超过15年的患者下肢神经CSA显著增加，EDB的CSA减小（19.89±0.98 vs 19.00±0.94；5.25±0.74 vs 5.93±0.94；均P<0.05）。
高频超声为诊断和监测DPN提供了有价值的影像学依据，显示糖尿病患者神经和肌肉参数有显著变化。
