Analysis Of Cross-sectional Area And Elastography Of Tibial Nerve In Type 2 Diabetic Peripheral Neuropathy

Objective: To measure the anteroposterior diameter and cross-sectional area of the tibial nerve of type 2 diabetic patients and normal control subjects by using high-frequency ultrasonography.To compare the anteroposterior diameter and CSA of tibial nerve between type 2 diabetic patients with peripheral neuropathy(DPN group),type 2 diabetic patients without peripheral neuropathy(non-DPN group) and control group.At the same time,elastography was used to analyze the Strain ratio of tibial nerve to provide the basis and possible diagnosis for the diagnosis and treatment of type 2 diabetic peripheral neuropathy.The relevance of FPG and HbA1c to CSA was analyzed.Methods: Sixty diabetic patients with complete data on hospitalizations from January 2017 to January 2018 were selected,was divided:30 case of DNP group,30 case of non-DNP group,control group of 30 case.(1)measure left and right tibial nerve anteroposterior diameter and CSA.(2)measure strain ratio of tibial nerve and flexor digitorum longus.(3)SPSS20.0 software for statistical analysis of the data.Comparing the differences of anteroposterior diameter,CSA and SR between left and right tibial nerve in DPN group,non-DPN group and control group,The ROC of CSA in both DPN and non-DPN groups was analyzed.(4)The correlation between FPG,HbA1c and CSA of peripheral neuropathy was analyzed.Results:(1)Compare the three groups of anteroposterior diameter and CSA,the DPN group was the largest and the normal group was the smallest(P <0.05).(2)There were significant differences in the SR ratio among the three groups(P<0.05).(3)The CSA of the left tibial nerve :Sensitivity was 0.867,specificity was 0.800,and the area under the ROC curve was 0.807.The CSA of the right tibial nerve : Sensitivity was 0.767,specificity was 0.800 and area under the ROC curve was 0.796.(4)The correlation coefficient between PGF and right tibial nerve cross section was 0.625,between PGF and left tibial nerve cross section was 0.516,between HbA1c and right tibial nerve cross section was 0.583,between HbA1c and left tibial nerve cross section was 0.556,P<0.05.Conclusions:(1)The anteroposterior diameter and CSA of tibial nerve in diabetic peripheral neuropathy group are significantly higher,which can provide some quantitative criteria for the diagnosis of diabetic peripheral neuropathy.(2)Elastography has certain potential value in the diagnosis of diabetic peripheral neuropathy.(3)Moderate positive correlation was significantly shown between FPG and the CSA of diabetic peripheral neuropathy,HbA1c and the CSA of diabetic peripheral neuropathys.