The normal value and influencing factors of shear wave elastography in healthy tibial nerves: A cross‐sectional study

Abstract

Background and Aims: Shear wave elastography is a potential method for evaluating peripheral neuropathy, but lacking reference values. The aim of this study was to measure tibial nerve stiffness in healthy individuals using shear wave elastography and to investigate the influencing factors of tibial nerve stiffness.Methods: Shear wave elastography of bilateral tibial nerves was performed in 50 healthy individuals 4 cm proximal to the medial malleolus. Mean shear modulus data of tibial nerves were obtained and recorded. Intra-and interobserver agreement were assessed using intraclass correlation coefficients. Differences among groups (grouped by laterality, sex, age, and body mass index) were analyzed with independent-samples t-tests and paired t-tests. Effect size (Cohen's d) was also calculated. Results:The intra-and interobserver agreement were moderate (intraclass correlation coefficient, 0.700-0.747) for all participants, and was poor (intraclass correlation coefficient, 0.265-0.088) in very thin people (body mass index <18.5 kg/m 2 ). The shear wave elastography measurements of the tibial nerve did not show a significant difference between legs, sexes, or different age groups.Higher values of tibial nerve stiffness were found in thinner participants.Conclusions: Shear wave elastography is a method to evaluate the stiffness of peripheral nerves. The measurement results were likely influenced by body mass index of the participants.

Using ultrasound shear wave elastography to characterize peripheral nerve mechanics: a systematic review on the normative reference values in healthy individuals

“…One study measuring the shear wave velocity of the median and tibial nerves observed that male participants had significantly higher shear wave velocities for the median nerve than female participants, but no differences were observed regarding the tibial nerve [ 43 ]. Similar findings were reported in another study [ 42 ] that observed no differences in the stiffness of the tibial nerve between male and female participants. Conflicting results have been reported on the effect of ageing on nerve shear wave velocity.…”

“…The reported values show high variability for both the tibial (range, 2.3 to 9.1 m/s) and the sciatic nerves (range, 1.9 to 9.9 m/s). Most of the studies included young adults, while three studies [ 39 , 42 ] compared nerve shear wave velocity between younger and older participants. Hirata et al [ 39 ] showed significantly lower sciatic nerve shear wave velocities in older adults than in younger adults.…”

“…Hirata et al [ 39 ] showed significantly lower sciatic nerve shear wave velocities in older adults than in younger adults. As for the tibial nerve, conflicting results were observed, with one study reporting higher tibial nerve shear wave velocities in older participants than younger participants [ 42 ], while another study [ 37 ] found a significant, moderate, and negative correlation (r=-0.58) between the tibial nerve shear wave velocity and age.…”