The Application Value Of High-frequency Ultrasound In Diagnosis Of Diabetic Peripheral Neuropathy

Propose To summarize the high-frequence ultrasound features of type 2diabetic peripheral neuropathy(DPN)patients,and to analyze the correlation between it and neural eletrophysiological examination,so as to study the application value of high-frequency ultrasound in diagnosis of diabetic peripheral neuropathy.Methods According to neural eletrophysiological examination,112 patients with type 2 diabetes were divided into the non-diabetic peripheral neuropathy group(A group,54 Patients)and diabetic peripheral neuropathy group(B group,58patients),and 49 non-diabetic patients were enrolled as the control group(C group).The width(W),thickness(T)and cross-sectional area(CSA)were measured in seven points of median nerve.Then,the ultrasound imaging features and change were observed,including blood flow,internal structure and internal echo.Moreover,the correlation between ultrasound and neural eletrophysiological examination was analyzed,and the receiver operating characteristic curve(ROC)was analyzed at different measurement sites of median,so as to determine the cutoff value of cross-sectional area.In addition,the effects of biochemical indexes and the course of diabetes on the disease were analyzed.Results 161 participants,85 are men,76 are women,average age is60.35±11.69 years old.(1)Overall,the differences between the three groups were statistically significant,especially at the level of carpal tunnel,which are MN4,MN5and MN6.Compared A group with C group,W,T and cross-sectional area of differences are not statistically significant at the level of MN1,MN2,MN3 and MN7,and W of difference is not statistically significant at the level of MN4,MN5.Others differences are statistically significant.Compared B group and C group,T of difference is not statistically significant at the level of MN2,and Others differences are statistically significant.Compared A group and B group,T of differences are not statistically significant at the level of MN1,MN2 and MN3,but Others differences are statistically significant.(2)At the wrist level,including MN4,MN5 and MN6,to observe the ultrasound features of median nerve dynamically.A group:11.7%showed blood flow signal,72.2%showed no screen structure,73.5%showed internal hypoechoic.Their differences were statistically significant.(3)On the basis of the Receiver operating characteristic curve,there is higher diagnosis value at MN5 and MN6 level,particularly at the MN6 level,and the cutoff value of cross-sectional area at A group and B group is 10.41mm~2 and 10.59mm~2,11.61mm~2 and 12.73mm~2,respectively.(4)The differences of neural eletrophysiological examination are statistically significant.According to correlation analysis,at the level of MN1,cross-sectional area is positively correlated with distal motor latency and is not correlated with others parameters.At the level of MN2,cross-sectional area is positively correlated with distal motor latency and F-average latency,and others are not correlation.At the level of MN3,cross-sectional area is positively correlated with distal motor latency and is negatively correlated with motor nerve action potential amplitude.At the level of MN4,MN5 and MN6,cross-sectional area is positively correlated with distal motor latency and F-average latency,and is negatively correlated with motor conduction velocity,sensory conduction velocity and motor nerve action potential amplitude.At the level of MN7,cross-sectional area is positively correlated with distal motor latency and F-average latency,and is negatively correlated with motor conduction velocity;(5)Compared A group and B group,fasting blood-glucose and glycosylated hemoglobin of difference are not statistically significant;(6)Compared A group and B group,course of disease of difference is not statistically significant.Conclusion Diabetic Peripheral Neuropathy,it presents the increase of W,T and cross-sectional area,particularly at the level of wrist,including MN4,MN5 and MN6.Moreover,it also shows the disappearance of screen structure,hypoechoic,thickened epineurium,there is no specifity due to low blood flow visualization.In addition,there is the correlation between ultrasound and neural eletrophysiological examination.To some extent,high-frequence ultrasound could help diagnose diabetic peripheral neuropathy early.Finally,fasting blood-glucose,glycosylated hemoglobin and course of disease are not very significant in the diagnosis of the DPN.