Preliminary Evaluation of the Sural Nerve Using 22-MHz Ultrasound: A New Approach for Evaluation of Diabetic Cutaneous Neuropathy

Abstract

BackgroundThe application of 22-MHz high-frequency ultrasound allows for visualization of the inner part of the sural nerve. The aim of this study was to evaluate the morphological changes of sural nerves in patients with type 2 diabetes mellitus using ultrasound.Materials and MethodsThe thickness/width (T/W) ratio, the cross-sectional area (CSA) of the sural nerves and the maximum thickness (MT) of the nerve fascicles were measured in 100 patients with type 2 diabetes mellitus and 50 healthy volunteers using 22-MHz ultrasound. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cut-off values as well as the sensitivities and specificities. All parameters were significantly different between the subject and control groups. The ROC curves demonstrated that the MT was the most predictive of diabetic cutaneous neuropathy, with an optimal cut-off value of 0.365 mm that yielded a sensitivity of 90.3% and a specificity of 87.7%.ConclusionsThe results of this study suggest that 22-MHz ultrasound may be a valuable tool for evaluating diabetic cutaneous nerve neuropathy.

Computer-assisted assessment of the histological structure of the human sural nerve

“…The results were compared between males and females as well as in regard to the side of the lower limb. We found that the average CSA of the sural nerve (0.14 cm 2 ) was similar to the results obtained by Belsack et al [1] -0.15 cm 2 and Liu et al [8] -0.168 cm 2 . However, our results significantly differed from those obtained by Pazzaglia et al [13] -0.34 cm 2 .…”

“…The number of examined cadavers was fairly small (n = 37). However, when compared with literature data, our findings are similar to the results obtained on larger groups [1,8]. The mean age of the cadavers was 60 years.…”

“…Literature analysis shows that previous researchers focused mainly on its anatomical variations [1,5,9,[14][15][16][17][18]. A limited number of studies concentrated on the histological analysis of the sural nerve [3,7,8,13]. Table 1 summarises the results of previous studies on the subject Total: n = 130 -To establish different patterns of cutaneous innervation of the SN on the dorsum of the foot…”

Ultrasound Findings After Surgical Decompression of the Tarsal Tunnel in Patients With Painful Diabetic Polyneuropathy: A Prospective Randomized Study

“…Liu et al (23) found a significantly increased CSA and T/W ratio in the sural nerve in people with diabetes with neuropathy compared with people with diabetes without neuropathy and with healthy control subjects. The CSA of the median nerve in the carpal tunnel of patients with DPN was greater than without DPN and healthy control subjects (24).…”

Challenges in sciatic nerve repair: anatomical considerations

“…To correlate our results with in vivo studies we reviewed ultrasound and MRI data from sciatic and sural nerves in healthy controls (Table 3). 9,16,23,26,42,44 These studies also demonstrate a large variability with regard to CSA, especially of the sural nerve. 9,15,16,26,44 Specifically, the sural nerve CSA as measured by ultrasound ranged from 1.44 to 5.3 mm 2 .…”