The Ultrasonography Characteristics Analysis Of Sural Nerve In Diabetic Peripheral Neuropathy Patients

Objective : We performed this study to observe the changes of sonography characteristics of ultrasonic images of sural nerve of patients with type II diabetes mellitus(DM)and peripheral neuropathy sural nerve, then analysed the correlation between the changes of the characteristics of the sural nerve in diabetic peripheral neuropathy(DPN)and age, disease course and function of nerve conduction,explored the value of ultrasound in the diagnosis of the sural nerve in DPN.Objects: During October 2013 to March 2015,120 cases of complete data of patients with type II DM were enrolled in our hospital,and 60 cases in gender, age matched healthy subjects were enrolled. According to the results of the clinical diagnosia of type II DM cases were divided into: 60 cases of DPN group and 60 cases of non-DPN group.Methods :(1) We observed the sonograms of the sural nerve, compared ultrasonographic between the DPN group, non-DPN group and the control group.(2) We measured the width and thickness of sural nerves, then calculated the cross sectional area( CSA) of sural nerve was calculated using formula CSA(mm2) = Width(mm) × Thickness(mm) × π/4;(3) Under the condition of constant temperature, relaxation, quiet, the subjects took the supine position, we used the application of ring electrodes on the subjects of the sural nerve sensory conduction velocity measurement. Applicated SPSS 20.0 software for data statistical analysis, we carried the normal distribution and ftest on the sample data,compared of DPN, non-DPN group and normal control group the difference between each measurement, P < 0.05 were thinked that the difference was statistically significant.Results 360 sural nerves were detected of all subjects, the epineurium, perineurium and the fasciculus of the sural nerve of normal control subjects can be clearly visible, epineurium and surrounding tissue boundary is clear. Normal sural nerve was a funicular by Slitting, it showed with parallel linear in the internal structure of the echoes; and it showed with screen mesh for elliptic shape structure of the echoby by cross cutting.According to the sonography of the sural nerve cross-sections in T2 DM groups, varying degrees of swelling, echo reduction, obscure epineurium boundary owes clear or vague internal reticular structure were observed, especially in the DPN group.According to the ultrasound measurements, the sural nerve width, thickness and CSA were changed incrementally in order of the normal group, the non-DPN group and DPN group, P<0.05.The SCV of the subjects’ sural nerve was more than 41.0m/s with the non-DPN group, but the ultrasonic manifestations has changed, Suggested that patients with diabetes has been in existence before nerve dysfunction of nerve abnormalities.Correlation analysis showed that the correlation coefficient between CSA and SCV was-0.035 in the DNP group with a corresponding significance level of P=0.855.Conclusion Sural nerve of high frequency ultrasound can provide imaging basis for clinical diagnosis of DPN;For the diagnosis and follow-up of DPN provide a certain amount of quantitative criteria; The non-DPN group of sural nerve ultrasonic signs change before the nerve dysfunction. Therefore, performing a sural nerve high-frequency ultrasonography in DM patients may provide more intuitive diagnostic information to early identification of peripheral neuropathy, thus providing a basis for the clinical treatment of DPN.