Ultrasound exploration of muscle characteristic changes and diabetic peripheral neuropathy in diabetic patients

Abstract

Purpose Using brightness mode ultrasound combined with shear wave elastography, this study aims to detect structural and functional changes of the medial head of gastrocnemius (MG) in type 2 diabetes mellitus (T2DM) patients with or without diabetic peripheral neuropathy (DPN). Methods 149 T2DM patients (DPN group and non‐DPN group) and 60 healthy volunteers (control group) were enrolled. We measured the absolute difference of fascicle length (FL), pennation angle (PA), and shear wave velocity (SWV) of both MG in neutral position and maximal ankle joint's plantar flexion and calculated ΔFL, ΔPA, and ΔSWV. These three parameters, along with muscle thickness (MT), were compared among the three groups. Results In the DPN group, the MG's MT, ΔPA, and ΔSWV were significantly lower than in the non‐DPN group (p < 0.01); these parameters achieved the highest scores in the control group (p < 0.01). The area under the receiver operating characteristic curve of the combination of ΔSWV and ΔFL was the largest for predicting inpatients with or without DPN. Conclusions Decreased muscle mass (MT) and muscle contractibility (ΔFL and ΔSWV) were detected in patients with T2DM, with or without DPN. ΔSWV and ΔFL of the MG showed high‐diagnostic accuracy for DPN warning signs.

Application Progress of Ultrasound Elastography in the Evaluation of Diabetic Peripheral Neuropathy

“…While Harish et al [23] evaluated the alterations of Achilles tendon in type 2 diabetic patients and concluded that the patients had thicker tendons (P < 0.01) and lower mean shear wave velocity values (P < 0.001) compared to healthy volunteers, indicating tendon softening in diabetic patients. In a recent study [24], the medial head of the gastrocnemius (MG) of T2DM was measured for absolute differences in three parameters In addition, SWE can improve its diagnostic sensitivity and specificity when applied in combination with a clinical neurological scoring system and biochemical indicators to assess DPN. Wang et al [25] applied SWE in combination with the Toronto clinical scoring system to diagnose DPN.…”

The Relationship between Muscle Ultrasound Parameters and Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

“…For large muscle groups of lower extremities, Wang et al [ 19 ] discovered that diabetes duration over ten years and rectus femoris mass index (RFMI) lower than 2.2 cm 2 /m 2 were indicators of DPN with an accuracy of 0.75 (95% CI: 0.72–0.79, p < 0.001). Zhao et al [ 20 ] found that the muscle thickness and shear wave velocity of MG decreased among patients with DPN in the correlation analysis ( p < 0.01). However, no direct evidence showed the echo intensity of muscle performance among T2DM patients with and without DPN.…”