| Objective:To discuss the clinical value of high-frequency ultrasonography and sonoelastography in evaluating the morphological and elasticity abnormalities of plantar fascia in patients of type 2 diabetes mellitus(T2DM).Methods: Sixty-five T2 DM patients were enrolled and divided into two groups: group C(31 cases,the course>10 years),group B(34 cases,the course?10 years).Thirty-eight healthy subjects were enrolled in group A as normal control.The echotexture and border of plantar fascia were observed by high-frequency ultrasonography.Each of plantar fascia was measured at its 1cm and 2cm distal from insertion locations(PF1 and PF2 points).The areas of PF1 and PF2 were formed with the center of PF1 and PF2 points and 1cm in length as the region of interest.The elasticity of the areas of PF1 and PF2 was assessed by real-time ultrasound elastography(RTE).The grades 1,2 and 3 of elasticity were obtained,and record normal persons and different course of T2 DM patients with the frequency of plantar fascia at all levels.Results: The ultrasound findings of longitudinal plane of plantar fascia in normal group A was displayed as a thin homogeneous hyperechoic band with small parallel lines and well-defined border with surrounding tissue.The ultrasound findings of plantar fascia in diabetic groups(group B and C)were displayed as decreased echotexture,inhomogenous,loss of normal striation and indistinct border with surrounding tissue.The comparision of rates of abnormalities: group B > group A,group C > group A,group C > group B(all P<0.05).The comparision of PF1 thickness: group B> group A,group C > group A,group C > group B(all P<0.05).The comparision of PF2 thickness:The PF2 thickness of group C was larger than that of group A(P<0.05).The PF2 thickness of group B > group A,group C > group B,But there was no significant difference between group B and group A,group B and group C(all P>0.05).The comparision of elasticity grading of PF1 area: the frequency of grade 1 of group B and group C was larger than that of group A,and so was it with group C and group B(all P<0.05).And the frequencies of the grade 2 and grade 3 of group B and group C were smaller than that of group A,and so was it with group C and group B(all P<0.05).The comparision of elasticity grading of PF2 area: the frequencies of grade 1 and grade 2 of group B and group C were larger than that of group A,the frequency of grade 3 of group B and group C was smaller than that of group A,but there were no significant differences among the group A,group B and group C in the elasticity grading of PF2 area(all P>0.05).Conclusion:Being as an effective imaging diagnosis method,high frequency ultrasound can be used to evaluate plantar fascia disease and to display plantar fascia two-dimension morphological changes clearly.And abnormal changes such as decreased echotexture,inhomogenous,loss of normal striation,indistinct border with surrounding tissue and thickness increase can be found in the plantar fascias of the patients of T2 DM with the increase of the course.And the sonoelastography is a new method of imaging technology which can show tissue elasticity and hardness.The abnormal elastic changes of plantar fascia of the patients with T2 DM can be observed to make us have a further understanding on the mechanical properties of the plantar fascia in different clinical course of the patients of T2 DM.Therefore,the abnormalities of the two-dimensional images and elasticity of the plantar fascia in the patients of T2 DM can be evaluated by high-frequency ultrasonography and sonoelastography in the early stage..They also provide objective basis of plantar fascia pathological changes for clinical diagnosis and treatment.It is with important clinical significance in early prevention diagnosis and treatment in the patients of T2 DM diabetic foot ulcer and improvement of prognosis. |
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