Comparison of High-Frequency Ultrasound and Acoustic Radiation Force Impulse Imaging in Diagnosis of Tibial Nerve Damage in Type 2 Diabetes Mellitus
Objective To compare and analyze the clinical value of high-frequency ultrasound and acoustic radiation force impulse imaging(ARFI)in the diagnosis of tibial nerve damage in type 2 diabetic peripheral neuropathy.Methods A total of 168 patients with type 2 diabetes who were treated in Weihai Central Hospital Affiliated to Qingdao University from June 2022 to June 2023,and 60 healthy volunteers who had no history of diabetes,peripheral neuropathy and clinical symptoms were randomly selected as the research objects.Neuro-electrophysiological examination(NEE)was performed in 168 patients with type 2 diabetes,and 60 patients with positive NEE results and clinical signs of peripheral neuropathy were selected as diabetic peripheral neuropathy(DPN)group.And 60 patients with type 2 diabetes were selected,who were required to have negative NEE results and no clinical signs of peripheral neuropathy,and served as non-diabetic peripheral neuropathy(NDPN)group.And 48 patients with type 2 diabetes who did not meet the conditions for inclusion were excluded.The control group selected 60 healthy volunteers in the same period.The tibial nerve 3-5 cm above the medial malleolus was selected for high-frequency two-dimensional gray-scale imaging and ARFI,and the anteroposterior diameter,left-right diameter and cross-sectional area(CSA)of the tibial nerve were measured in two dimensions.The shear wave velocity(SWV)was measured by virtual touch tissue imaging and quantification(VTIQ),and the diagnostic value of each data in diagnosing DPN was compared.Receiver operating characteristic curve(ROC curve)was drawn,and the area under the curve was calculated,and the value of conventional ultrasound and ARFI in quantitative diagnosis of type 2 diabetic peripheral neuropathy was compared.Results Among DPN group,NDPN group and control group,the left and right diameter of tibial nerve[left side:(4.53±0.59)mm,(4.16±0.37)mm,(3.90±0.34)mm;right side:(4.45±0.58)mm,(4.19±0.41)mm,(3.99±0.37)mm],CSA[right side:(22.27±3.90)mm2,(19.00±3.18)mm2,(17.37±3.48)mm2;right side:(21.80±3.27)mm2,(19.10±3.34)mm2,(17.57±3.71)mm2]were compared,and the differences were statistically significant(P<0.05).Tibial nerve SWV[left side:(2.47±0.27)m/s;right side:(2.48±0.27)m/s]in DPN group was higher than that in NDPN group[left side:(2.23±0.11)m/s;right side:(2.25±0.10)m/s]and control group[left side:(1.99±0.07)m/s;right side:(1.99±0.06)m/s],NDPN group was higher than control group,the differences were statistically significant(P<0.05).According to the measured results,ROC curves were plotted respectively.The sensitivity of anterior and posterior diameter of tibial nerve was 0.567,the specificity was 0.617,and the area under the curve was 0.583(P=0.133).The sensitivity of tibial nerve was 0.583,the specificity was 0.733,and the area under the curve was 0.671(P=0.024).The CSA sensitivity of tibial nerve was 0.717,the specificity was 0.683,and the area under the curve was 0.731(P<0.001).ARFI tibial nerve SWV sensitivity was 0.700,specificity 0.733,and area under the curve 0.783(P<0.001).Conclusion Both high-frequency two-dimensional gray-scale imaging and ARFI imaging have diagnostic value for DPN in type 2 diabetes mellitus,and ARFI imaging is more significant.
ultrasound examinationtype 2 diabetes mellitusdiabetic peripheral neuropathytibial nerveacoustic radiation force impulse imagingvirtual touch tissue imaging and quantification
万方数据
维普
