Detection Of Upper Limbs Main Nerves Of Normal Adults And Type2Diabetes Mellitus Patients With Peripheral Neuropathy By High-Frequency Ultrasonography

Objective：To discuss the scanning methods and the ultrasonographic features ofnormal adults’ median nerve,radial nerve and ulnar nerve by using high frequencyultrasound. And to evaluate the abnormalities of the main nerves of upper limbs in type2diabetes mellitus (T2DM) patients and T2DM with peripheral neuropathy (DPN)patients through contrast with those of normal adults by high-frequencyultrasonography and discuss its clinical values.Methods：A high-frequency linear array transducer was used to detect mediannerve, radial nerve and ulnar nerve for bilateral upper limbs. The ultrasonographiccharacteristics of the nerve were observed in30cases of normal adults. The length andwide diameters were measured in transverse sections and the cross-sectional areas werecalculated.60T2DM patients were divided into two groups: group A (T2DM with DPN,30cases); Group B (T2DM without DPN,30cases), the above30cases of noarmaladults were enrolled as group C (control group). The internal echoes and the structuresof median nerves, radial nerves and ulnar nerves were observed. The length diameter(D1), wide diameter (D2) and cross-sectional area (CSA) in corresponding segmentswere measured.Results：All median nerves, radial nerves and ulnar nerves were showed clearly byhigh-frequency ultrasonography. There were no significant differences among thelength diameters, wide diameters and cross-sectional areas of the nerves of the twoupper limbs. The transverse section of median nerves, radial nerves and ulnar nerves ofgroup C presented hyperechogenicity, with hypoechogenicity in central part, lookinglike gridding changes. The longitudinal section shows the hypoechoic parallel linealstructures which were striped by hyperechogenicity intermittently. The internal echoesof median nerves, radial nerves and ulnar nerves of group A were decreased obviously. The hypoechoic parallel lineal structures disappeared, and D1, D2and CSA were largerthan those of group B and group C (all P<0.05). Compared with group C, the internalechoes of nerves in group B were only decreased at the levels of carpal tunnel, elbowulnar nerve tube and Guyon tube. The D1, D2and CSA were larger than those of groupC (all P<0.05).Conclusion：Median nerve, radial nerve and ulnar nerve of normal persons can bemeasured and demonstrated clearly by high frequency ultrasound. The abnormalities ofinternal echoes,diameters and cross sections of main nerves of upper limbs in T2DMpatients with and without DPN can be displayed clearly by high-frequencyultrasonography with important clinical values.