Diagnostic value of shear wave ultrasound elastography of tibial nerve in patients with diabetic peripheral neuropathy

Ibrahim, Heba R.

doi:10.1186/s43055-022-00779-z

Cited by 4 publications

(1 citation statement)

References 36 publications

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“…With an Emean optimum cut-off value of 67.55 kPa the AUC was 0.765, which had the highest diagnostic value. Which is broadly consistent with Ibrahim Heba R ‘s findings [ 26 ]. Based on the optimal cut-off values obtained from the ROC curve, we retrospectively concluded as follows.…”

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confidence: 92%

Evaluation of the clinical value of shear wave elastography for early detection and diagnosis of diabetic peripheral neuropathy: a controlled preliminary prospective clinical study

Wang

Zhou

et al. 2022

BMC Musculoskelet Disord

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Purpose This study aims to analyze the clinical application value of shear wave elastography (SWE) technique for early diagnosis of diabetic peripheral neuropathy (DPN). Methods Diabetic patients hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University from August 2021 to February 2022 were enrolled as DPN group (n=38) and non-DPN group (n=35) based on the neurophysiological examination results. 30 healthy subjects were recruited as the control group during the same period. Ultrasound examination of the tibial nerve and related laboratory tests were examined and collected for the total 103 study subjects. Statistical analysis of the collected data, and the receiver operating characteristic(ROC) curve for determination of the optimal cut-off values of mean stiffness of tibial nerve to detect DPN, with determination of area under curve (AUC), specificity, sensitivity, and Youden index.P value < 0.05 is considered statistically significant. Results Gender, age and BMI differences among three groups were insignificant (P>0.05). The difference of serological indicators between DPN and non-DPN groups was also not found (P>0.05), whereas longer duration of diabetes was observed in DPN group as compared to non-DPN group. As to the ultra-sound relevant parameters, the cross-sectional area and elastic modulus of the tibial nerve in both lower extremities among these three groups were not significantly different (Oneway ANOVA analysis) although the differences were indeed observed if we compared DPN group exclusively with non-DPN group, or compared non-DPN group with healthy group, or compared DPN group with healthy group (t test). Additionally, the mean elasticity (Emean) cut-off value for the diagnosis of DPN was preferably taken as 67.55 kPa. Conclusion SWE has unique advantages in early detection and diagnosis of DPN, which deserve further research.

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Section: Discussionsupporting

confidence: 92%

Evaluation of the clinical value of shear wave elastography for early detection and diagnosis of diabetic peripheral neuropathy: a controlled preliminary prospective clinical study

Wang

Zhou

et al. 2022

BMC Musculoskelet Disord

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Multi-parametric high resolution ultrasound assessment of tibial nerve in diabetic peripheral neuropathy

Elsayed,

Settein,

Abd Elkhalek

et al. 2024

Egypt J Radiol Nucl Med

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Background Diabetic peripheral neuropathy (DPN) is a common and serious complication of diabetes occurring in about 50% of patients. It serves as a strong risk factor for disabling pain, foot ulcers and amputation that have a negative effect on the life quality and bring a heavy economic burden. Therefore, it is important to early diagnose DPN for taking influential targeted measures and preventing foot ulcers and amputations. The aim of this study was to assess the role of different high resolution ultrasound (HRUS) parameters in diagnosing DPN. Results This study included 60 participants classified into three groups [20 diabetic cases with DPN, 20 diabetic cases without peripheral neuropathy (PN) and 20 age-/sex-matched healthy control]. All cases underwent full clinical and laboratory investigations. HRUS examination including shear wave elastography (SWE) of the tibial nerve was also performed. Our study revealed statistically significant difference as regard maximum thickness nerve fascicles (MTNF) between DPN and control groups (P = 0.005) with a cutoff value of 0.45 mm yielding 85% sensitivity and 75% specificity. As regard nerve cross-sectional area (CSA), there was significant statistical difference between each of the three studied groups. A cutoff value of 17.5 mm2 was excellent in differentiating DPN group from control group with 80% sensitivity and 95% specificity. The highest mean nerve stiffness was noted among DPN group compared to diabetics without PN and control groups with significant statistical difference between each of the studied groups. The mean nerve stiffness was excellent in differentiating DPN group from control group with 100% sensitivity and 100% specificity. There was significant statistical positive correlation between neuropathy disability score and diabetes duration, HbA1c levels, MTNF, nerve CSA and stiffness. Conclusions Multi-parametric HRUS using MTNF, CSA and SWE is a promising quantitative technique that has an excellent additive value to the usual qualitative nerve examination. High image quality, real-time examination, non-invasiveness, low cost, wide availability and multi-parametric assessment make HRUS superior to nerve conduction test. It can serve as an accurate novel technique for screening and early diagnosis of DPN even with normal clinical and nerve conduction studies.

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Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis

Senarai,

Suwannakhan,

Pratipanawatr

et al. 2023

JCM

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Background: High-resolution ultrasound of the tibial nerve has been used for screening of several neurologic disorders, but normative reference values of tibial nerve cross-sectional areas (CSA) have not been well established. Thus, the present meta-analysis was performed to generate normative estimates of tibial nerve CSA at various sites of the lower limb based on ultrasonography. Methods: Google Scholar, Scopus and PubMed were searched for potential studies. Studies were required to report tibial nerve CSA in healthy individuals to be included. A random-effect meta-analysis was performed to calculate tibial nerve CSA values. Subgroup and statistical analyses were performed to study covariates. Results: Forty-eight eligible articles consisting of 2695 limbs were included. The average tibial nerve CSA was found to be 10.9 mm2 at the ankle (95% CI: 9.9–11.8) and should not exceed 11.8 mm2 in healthy adults. At the popliteal fossa, the overall CSA was 21.7 mm2 (95% CI: 17.5–25.8) in healthy adults. At both sites, the average tibial nerve CSA was significantly larger in adults than in children, and the differences by geographical region were not statistically significant. At the ankle, tibial nerve CSA increased with age and body mass index, while at the popliteal fossa it increased with age and weight. Conclusions: our findings indicate that the tibial nerve varied not only along its course but also among sub-variables. Establishing normal references values of tibial nerve CSA is helpful to differentiate healthy from diseased tibial nerves such as in diabetic peripheral neuropathy or tarsal tunnel syndrome.

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Diagnostic value of shear wave ultrasound elastography of tibial nerve in patients with diabetic peripheral neuropathy

Cited by 4 publications

References 36 publications

Evaluation of the clinical value of shear wave elastography for early detection and diagnosis of diabetic peripheral neuropathy: a controlled preliminary prospective clinical study

Evaluation of the clinical value of shear wave elastography for early detection and diagnosis of diabetic peripheral neuropathy: a controlled preliminary prospective clinical study

Multi-parametric high resolution ultrasound assessment of tibial nerve in diabetic peripheral neuropathy

Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis

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