Application value of conventional ultrasound and real-time shear wave elastography in patients with type 2 diabetic polyneuropathy

Chen, Rui; Wang, Xiaolei; Xue, Wei-Li; Sun, Jiawei; Xueying, Dong; Jiang, Zhao-Peng; Wu, Han; Ma, Rao; Zhou, Xian‐Li

doi:10.1016/j.ejrad.2020.108965

Cited by 18 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, the diabetic group had a stiffer sciatic nerve and greater nerve block than those of the control group. These findings were consistent with those previously reported by Dikici et al [ 10 ] and Chen et al [ 33 ], who showed that the tibial nerve in patients with established neuropathy was significantly stiffer than that in healthy controls. Nevertheless, it is noteworthy that nerve tissue has viscoelastic properties [ 34 ].…”

Section: Discussionsupporting

confidence: 94%

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Liu

Xin

et al. 2022

Korean J Radiol

View full text Add to dashboard Cite

Objective Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group ( p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group ( p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group ( p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA ( p = 0.030) and 0.705 for SWE ( p = 0.035). Conclusion Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

show abstract

Section: Discussionsupporting

confidence: 94%

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Liu

Xin

et al. 2022

Korean J Radiol

View full text Add to dashboard Cite

show abstract

“…[ 17 , 26 ] These mechanisms have been investigated by studies both in diabetic patients and in rats. [ 32 , 33 ]…”

Section: Discussionmentioning

confidence: 99%

“…Despite normal electrophysiological examination results, these diabetic patients may have already suffered some nerve damage. [ 32 ] Therefore, SWE has potential value in the early detection of subelectrophysiological DPN, in which some nerve changes have occurred but electrophysiological examination remains negative. Early diagnosis of DPN is essential in that it allows for initiating treatment at the earliest stages of DPN with subsequent minimization of future complication, which decrease both short-term and long-term morbidity.…”

Section: Discussionmentioning

confidence: 99%

Value of shear wave elastography combined with the Toronto clinical scoring system in diagnosis of diabetic peripheral neuropathy

Wang

Zheng

et al. 2021

Medicine

View full text Add to dashboard Cite

To evaluate the diagnostic values of shear wave elastography (SWE) alone and in combination with the Toronto clinical scoring system (TCSS) on diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). The study included 41 DPN patients, 42 non-DPN patients, and 21 healthy volunteers. Conventional ultrasonography and SWE were performed on the 2 sides of the tibial nerves, and cross-sectional area (CSA) and nerve stiffness were measured. TCSS was applied to all patients. A receiver operating characteristic curve analysis was performed. The stiffness of the tibial nerve, as measured as mean, minimum or maximum elasticity, was significantly higher in patients in the DPN group than the other groups ( P < .05). The tibial nerve of subjects in the non-DPN group was significantly stiffer compared to the control group ( P < .05). There was no significant difference of the tibial nerve CSA among the 3 groups ( P > .05). Mean elasticity of the tibial nerve with a cutoff of 71.3 kPa was the most sensitive (68.3%) and had a higher area under the curve (0.712; 0.602–0.806) among the 3 shear elasticity indices for diagnosing DPN when used alone. When combining SWE with TCSS in diagnosing DPN, the most effective parameter was the EMax, which yielded a sensitivity of 100.00% and a specificity of 95.24%. SWE is a better diagnostic tool for DPN than the conventional ultrasonic parameter CSA, and a higher diagnostic value is attained when combining SWE with TCSS.

show abstract

“…The key is that, in type 2 diabetic patients, fibers in the sheaths of peripheral nerves thicken, resulting in an elastic change of the tibial nerve (Table 3 and Figure 7). [66][67][68] Further studies are required to explore the mechanisms that underlie elastic changes in multiple peripheral nerves in DM patients at follow-up.…”

Section: Improving the Diagnostic Value In Dpn By Shear Wave Sonoelasmentioning

confidence: 99%

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Huang¹,

Wu²

2021

DMSO

View full text Add to dashboard Cite

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM). The typical manifestation is a length-dependent "glove and sock" sensation. At present, diagnosis is mainly dependent on clinical manifestations. Since the pathogenesis is not clear, there are no effective treatment measures. Management consists mainly of glucose control, peripheral nerve nutrition, and other measures to delay the progress of the disease; early diagnosis is therefore crucial to improving prognosis and quality of life for patients with DPN. Due to the lack of obvious symptoms in 50% of patients and the low sensitivity of neuro-electrophysiology to small fibers, the missed diagnosis rate is high. Highresolution ultrasound (HRU), as a convenient noninvasive tool, has been proven by many studies to have excellent clinical value in diagnosing DPN. With the development of related new technology, HRU shows promise for the screening, diagnosing, and follow-up of DPN, which could serve as a biomarker and provide new diagnostic insights. In this paper, we review the ability of HRU to detect nerve cross-sectional area and blood flow, and echo and other image changes, and in showing the characteristics of peripheral nerve morphological changes in patients with DPN. We also explore the application of two other recent technological developments-shear wave elastography (SWE) and ultrasound scoring systems-in improving the diagnostic efficiency of HRU in peripheral neuropathy.

show abstract

Application value of conventional ultrasound and real-time shear wave elastography in patients with type 2 diabetic polyneuropathy

Cited by 18 publications

References 29 publications

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Value of shear wave elastography combined with the Toronto clinical scoring system in diagnosis of diabetic peripheral neuropathy

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Contact Info

Product

Resources

About