Zheng Siqi, Zhu Miao, Fan Gaoxiang, Yang Xueting, Bai Min
Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
Br J Radiol. 2025 Feb 1;98(1166):280-286. doi: 10.1093/bjr/tqae227.
To evaluate the value of conventional ultrasound (US), strain elastography (SE), and shear wave elastography (SWE) in detecting diabetic peripheral neuropathy (DPN) of the tibial nerve (TN), and to establish a predictive model for the diagnosis of DPN.
A total of 32 healthy participants, 34 diabetic patients without DPN, and 36 diabetic patients with DPN were recruited for this study. The TN at the ankle and popliteal fossa were selected for examination. US was used to measure the cross-sectional area (CSA) and perimeter of the TN. Additionally, SE was used to measure the strain ratio (SR) between the TN and the surrounding adipose tissue, and SWE was used to measure the shear wave velocity (SWV) of the TN.
The CSA, perimeter, SR, and SWV of the TN at the ankle were significantly higher in the DPN group compared to both the Non-DPN group and control group (P < .05). Similarly, the TN at the popliteal fossa showed these differences. At the ankle, the CSA, perimeter, SR, and SWV of the TN in patients without DPN were significantly higher than those in the control group (P < .05). At the popliteal fossa, the SR and SWV of the TN in patients without DPN were significantly higher than those in the control group (P < .05). However, the CSA and perimeter of the TN in patients without DPN did not show a statistically significant difference compared to the control group. The area under the curve (AUC) for the diagnosis of DPN using SWE is significantly greater than that of SE and US.
US, SE, and SWE could be used to diagnose DPN, and they also have good diagnostic value for sub-clinical DPN. Among these methods, SWE has demonstrated superior diagnostic efficacy. Compared to examining the TN in the popliteal fossa, the ankle level offers a better site for examination.
For diabetic peripheral neuropathy, US, SE, and SWE are all promising diagnostic methods with high clinical utility.
评估传统超声（US）、应变弹性成像（SE）和剪切波弹性成像（SWE）在检测胫神经（TN）糖尿病周围神经病变（DPN）中的价值，并建立DPN诊断预测模型。
本研究共纳入32名健康参与者、34名无DPN的糖尿病患者和36名有DPN的糖尿病患者。选取踝关节和腘窝处的TN进行检查。US用于测量TN的横截面积（CSA）和周长。此外，SE用于测量TN与周围脂肪组织之间的应变比（SR），SWE用于测量TN的剪切波速度（SWV）。
与非DPN组和对照组相比，DPN组踝关节处TN的CSA、周长、SR和SWV显著更高（P < 0.05）。同样，腘窝处的TN也显示出这些差异。在踝关节处，无DPN患者TN的CSA、周长、SR和SWV显著高于对照组（P < 0.05）。在腘窝处，无DPN患者TN的SR和SWV显著高于对照组（P < 0.05）。然而，无DPN患者TN的CSA和周长与对照组相比无统计学显著差异。使用SWE诊断DPN的曲线下面积（AUC）显著大于SE和US。
US、SE和SWE可用于诊断DPN，对亚临床DPN也具有良好的诊断价值。在这些方法中，SWE已显示出卓越的诊断效能。与检查腘窝处的TN相比，踝关节水平提供了更好的检查部位。
对于糖尿病周围神经病变，US、SE和SWE都是有前景的诊断方法，具有较高的临床实用性。
Zotero 插件