Sonographic Imaging of the Peripheral Nerves in Patients with Type 2 Diabetes Mellitus

Watanabe, Tsuneo; Kawachi, Shin-ichi; Matsuoka, Takeshi

doi:10.5772/21389

Cited by 3 publications

(11 citation statements)

References 44 publications

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“…However, the cut off for the ulnar, common peroneal and posterior tibial nerve in the present study had a high sensitivity and specificity in our population, and were lower than those found in other study groups 12,16 (common peroneal nerve 11.5 mm 2 ; posterior tibial nerve 14.5 mm 2 ). A possible reason could be the demographic differences among our study population with those conducted in other countries as described above.…”

Section: Discussioncontrasting

confidence: 92%

“…This leads to nerve swelling and also decreased echogenicity. 12 Interestingly, the nerves in asymptomatic diabetics were also more hypoechoic when compared to the control group.…”

Section: Discussionmentioning

confidence: 97%

“…Our study demonstrated a pronounced increase in CSA for all the examined nerves in diabetic patients when compared to controls .This is in agreement with several previous studies. 7,12,14–21 Nearly all researchers except Hobson et al. 22 reported an enlarged CSA on sonography in peripheral nerves of diabetic patients with DPN in comparison with a control population.…”

Section: Discussionmentioning

confidence: 99%

“…Though the exact mechanism of DPN is uncertain it has been proposed that oxidative stress triggered by microangiopathy in the nerve and accumulation of hyperglycaemia-induced sorbitol in Schwann cells are the key pathological processes that induce demyelination and axonal nerve damage. 12,13 These changes are manifested as morphological alterations in nerves.…”

Section: Discussionmentioning

confidence: 99%

“…With the use of ImageJ software, the amount of the hypoechoic area falling below the threshold echo intensity was calculated as detailed by Watanabe et al. 12 ImageJ is a public domain Java-based image processing program developed at the National Institutes of Health and the Laboratory for Optical and Computational Instrumentation (LOCI, University of Wisconsin). It can calculate area and pixel value statistics of user-defined selections.…”

Section: Methodsmentioning

confidence: 99%

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High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool

et al. 2020

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Introduction Detection of subclinical neuropathy can aid in triage, timely intervention and dedicated care to reduce disease progression and morbidity. High resolution sonography has emerged as a promising technique for evaluation of peripheral nerves. The aim of the present study was to assess the utility of high resolution sonography in screening diabetic patients for subclinical neuropathy. Methods A total of 70 adult patients with type 2 diabetes mellitus and 30 controls were enrolled; those with clinical features of neuropathy constituted the diabetic polyneuropathy group and those without symptoms/normal nerve conduction the non-diabetic polyneuropathy group. After institutional ethical committee approval and informed consent, high resolution sonography was performed by two musculoskeletal radiologists. Nerves studied were median (elbow and wrist), ulnar (cubital tunnel and Guyon’s canal), common peroneal (fibular head) and posterior tibial nerve (medial malleolus).The size (cross sectional area), shape, echogenicity and morphology of nerve were assessed and compared between the groups. Results The mean cross sectional area of all nerves was significantly higher both in diabetic polyneuropathy and non-diabetic polyneuropathy group compared to controls (p value < .001). Common peroneal nerve cross sectional area of 4.5 mm2 had the highest sensitivity (93%) and specificity (86%) for detecting nerve changes in the non-diabetic polyneuropathy group. The nerves were more rounded, hypoechoic and had an altered morphology in both study groups. Conclusion Presence of sonographic nerve changes in asymptomatic diabetics depicted that morphological alterations in nerves precede clinical symptoms. High resolution sonography detected nerve changes with a good accuracy, and thus, can be a potential screening tool for detection of subclinical diabetic polyneuropathy.

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Section: Discussioncontrasting

confidence: 92%

“…This leads to nerve swelling and also decreased echogenicity. 12 Interestingly, the nerves in asymptomatic diabetics were also more hypoechoic when compared to the control group.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool

et al. 2020

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Ultrasound features of diabetic peripheral neuropathy

Lopez-Delgadillo,

Salazar-Lopez

2023

JMEXFRI

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Introduction. Diagnosis of diabetic peripheral neuropathy (DPN) on a clinical basis alone is inaccurate. Ultrasound (US) abnormalities of DPN have been reported. This study describes the qualitative and quantitative US features of DPN in type 2 diabetes mellitus (T2DM) patients with and without symptomatic DPN. Material and Methods: This retrospective cross-sectional study in T2DM patients assessed the proximal and distal segments of the median and tibial nerves with grayscale and color Doppler US. The qualitative US features recorded were loss of the epineurium margin, blurring of the honeycomb structure, and intraneural vascularity. The diameter of the cross-sectional area (CSA) was also quantified. Patients were grouped according to the presence or absence of DPN clinical symptoms such as dysesthesia and/or pain. Results: Eighty patients were included. Forty (50%) reported dysesthesia and/or neuropathic pain. The time since T2DM diagnosis was a mean of 11.4 years. Loss of the epineurium margin was the most prevalent feature, followed by blurring of the honeycomb structure and the presence of intraneural vascularity. CSA enlargement was found in the proximal segment of the median nerve in patients with symptomatic DPN. In T2DM patients without DPN symptoms, the CSA was almost normal. The CSA was normal in the distal segment in both groups. In contrast, a comparable CSA increase of the tibial nerve was found in both nerve segments in T2DM patients with and without DPN symptoms. Conclusion: This study is the first in Mexico to demonstrate the demonstrate the qualitative and quantitative ultrasonographic features of DPN in T2DM patients with or without neuropathic symptoms.

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The role of ultrasound in the diagnosis and evaluation of diabetic neuropathy in nerve roots of the foot

Mahmoud

Yousef

Said

et al. 2018

Sci J Al-Azhar Med Fac Girls

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Sonographic Imaging of the Peripheral Nerves in Patients with Type 2 Diabetes Mellitus

Cited by 3 publications

References 44 publications

High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool

High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool

Ultrasound features of diabetic peripheral neuropathy

The role of ultrasound in the diagnosis and evaluation of diabetic neuropathy in nerve roots of the foot

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