| Objective:Lower limb lesions are easily exposed to diabetes.Achilles tendon lesions will affect the quality of life of diabetic patients over time.Early discovery,is not an easy job,of lesions of the Achilles tendon may largely lead to better life of diabetic patients.Ultrasounic elastography has been able to be used to discover pathological change in a creative elastic way.Ultrasounic elastography,which is fast,noninvasive and cheap,of diabetic Achilles tendon have good correspondence with histological examination.Methods:A retrospective scientific research was made among 63 inpatients(32males,31 females)with T2 DM in January 2016 to November 2016 in the second hospital of Jilin university.Meanwhile 29 inpatients(10 males,19females)without T2 DM were also involved.All inpatients should aged from 50 to 55,and be asymptomatic(without Rheumatoid arthritis,spinal joint disease,high blood cholesterol,Achilles tendon synovitis,Achilles tendon peripheral disease,post-Achilles tendon bursal synovitis,or history of diabetic foot,history of Achilles tendon injury,history of lower limb amputation,history of special motor function exercise,etc)which may cause tendon elastic changes.Group 1 was composed of inpatients with T2 DM history less than 5 years.Group 2 was composed of inpatients with T2 DM history between 6 and 10 years.Group 3 was composed of inpatients with T2 DM history between 11 and 15 years.Group 4 was composed of inpatients with T2 DM history more than 16 years.We used Mindray Resona 7 ultrasonic diagnostic equipment to analyze the thickness and Young modulus of the distal one-third of Achilles’ Tendon and evaluate the image by traditional Utrasonalgraphy.Gender and duration would be collected to make comprehensive evaluation.All analyses were done by using IBM SPSS statistical software,release 22.0.Data that conformed to the normal distribution would be describe as mean ± standard.Those did not conform to the normal distribution would be describe as median(P25,P75).Least—Significant Difference test will be used if the normal distributed data satisfied variance homogeneity test,otherwise we used Dunnett-t test.For data did not conform to the normal distribution,we used Non-parametric method to compare difference between two groups.The pearson Correlation coefficient was used to calculate the correlation when the distribution of data was normal;otherwise spearman correlation coefficient was used.The significance level was determined at p<0.05.Results:1.In control group,the thickness of the left and right Achilles tendons was(0.576±0.165)cm,(0.582±0.188)cm,and there was no significant difference in the thickness of the bilateral Achilles tendons(p>0.05).Abnormal images can be found in normal Achilles tendons,such as: hypo-hyper Eco zone,wavy fiber,Irregular tendon edge.2.In T2 DM group,the thickness of the left and right Achilles tendons was respectively(0.651±0.010)cm,(0.678±0.014)cm,the difference of the thickness between the bilateral Achilles tendons was not significant(p>0.05).More abnormal images,such as hyper Eco zone and wavy fiber,were observed in T2 DM group(p<0.05).3.Between different gender,no significant difference was showed in thickness or Young ’s modulus of Achilles tendons(p>0.05).4.In T2 DM group,Achilles tendons were thicker than those in control group(p<0.05).We could not demonstrate the difference in the thickness of Achilles tendons between groups 1,2,3 and 4(p>0.05).5.In control group,the Young’s modulus of the left and right Achilles tendons was respectively 45.53(35.96,60.81)k Pa and 41.85(30.53,50.68)k Pa,showed no difference(p>0.05).6.The Young’s modulus of the left and right Achilles tendons was:(70.56±22.86)k Pa and(66.74±22.75)k Pa in group 1;65.87(55.45,97.58)k Pa and(70.30±26.70)k Pa in group 2;(87.135±25.82)k Pa and(75.42±20.89)k Pa in group 3;(77.52±31.32)k Pa and 69.79(56.46,77.10)k Pa in group 4.Comparing two groups out of group 1,2,3,4,only right Achilles tendons reach significant difference by comparing group 1 and group 3(p<0.05).7.The Young’s modulus of Achilles tendons in T2 DM group was statistically greater than those in control group(p<0.05).In T2 DM group,Young’s modulus were moderately correlated with the length of the disease.Left r = 0.45,p = 0.01;right r = 0.50,p = 0.01.Conclusions:1.As a common method of Achilles tendon examination,the two-dimensional signs of ultrasonography is irreplaceable in the diagnosis of Achilles tendon disease.2.The thickness and stiffness of Achilles tendons of asymptomatic T2 DM patients increased greatly compared to those of control peoples.Achilles tendon stiffness increased with the development of T2 DM.3.As a non-invasive method,Shear Wave Elastography can be used to quantitatively measure the stiffness of the Achilles tendon.To a certain extent,this technology can indicate the lesions of Achilles tendon by combining with clinical and other auxiliary examination,so as to avoid Achilles tendon rupture event in the future. |
PDF Full Text Request