High frequency ultrasound to assess nerve ending neuropathy in patients with diabetic foot

NewsBot · Oct 20, 2012

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The feasibility of using high frequency ultrasound to assess nerve ending neuropathy in patients with diabetic foot
Yuanyi Zhengemail et al
European Journal of Radiology; Article in Press

Objectives
The nerve ending problem is one of the major causes for diabetic feet. In this work, we explored the feasibilities of using high frequency ultrasound (US) in nerve ending problem evaluation for patients with diabetic foot.

Methods
The endings of the medial branch of deep peroneal nerves (mbDPN) were interrogated by US, and the nerve conduction characters were studied in a cohort of 19 clinically diagnosed diabetic feet patients and a control group of healthy volunteers.

Results
Distinct echoic appearances were consistently detected between the mbDPN nerves of diabetic feet patients and healthy volunteers. In healthy volunteers, hypoechoic bands were readily observed at the anatomical locations of mbDPNs. However, these hypoechoic bands of the mbDPNs were not clear in the diabetic feet patients, and the surfaces of the mbDPNs appeared obscure and irregular in these patients relative to those of healthy volunteers. In addition, the US echoes of mbDPN in patients with diabetic feet were more heterogeneous than those in healthy volunteers. The mean diameters of mbDPNs were 1.3±0.4mm in patients with diabetic foot and 0.8±0.2mm in the control group (P<0.05). Finally, results from the nerve conduction studies (NCS) showed abnormalities in patients with diabetic feet syndrome.

Conclusion
High frequency US can be a useful modality for evaluating nerve ending problems in diabetic feet patient; and the mbDPN enlargement, obscurity, surface irregularity and heterogeneity in echo can serve as the markers indicating nerve ending problems in the diabetic feet patients under ultrasound interrogation.
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Admin2 · Oct 20, 2012

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NewsBot · Sep 15, 2023

Shear wave elastography of tibial nerve in patients with diabetic peripheral neuropathy-A cross-sectional study
Dhiri Ranjan Pradhan et al
Skeletal Radiol. 2023 Sep 12

Objective: To explore the role of shear wave elastography of the tibial nerve as a potential ultrasonographic method for the diagnosis of tibial neuropathy in patients with type 2 diabetes.

Materials and methods: This cross-sectional study included 50 subjects each in case (patients with diabetic tibial neuropathy diagnosed on the basis of clinical features and nerve conduction study) and control groups (non-diabetic non-neuropathic healthy volunteers). The exclusion criteria included the presence of type 1 diabetes, a known history of neuropathy from other causes except for type 2 diabetes, or a history of leg or ankle fracture. Cross-sectional area and shear wave velocity values of the tibial nerve were measured in both groups. Demographic details and body mass index were obtained in both groups and additionally, the duration of type 2 diabetes and HbA1c values in the case group were also noted. Wilcoxon Mann-Whitney U test was used to compare these variables in study groups. ROC curve analysis provided additional findings.

Results: Tibial nerve stiffness was significantly higher in the case group (p-value < 0.001). The study groups did not significantly differ in the Cross-sectional area of the tibial nerve (p-value 0.57). The case group exhibited a higher frequency of loss of the fascicular pattern of the tibial nerve (40% vs 18%, p-value 0.027). Duration of diabetes mellitus and HbA1c values did not significantly affect Shear wave velocity values in the case group. At the cut-off value of Shear wave velocity of 3.13 m/s, sensitivity and specificity to diagnose diabetic peripheral neuropathy were 94% and 88% respectively.

Conclusion: Increased nerve stiffness is seen in patients with diabetic peripheral neuropathy. Shear wave elastography might prove as a novel noninvasive technology for screening/early diagnosis of diabetic peripheral neuropathy.
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