| 赵威,郭瑞君,吴玥,曹文,卢瑞刚,吕朝阳,尹莉,吕秀章.剪切波弹性成像观察糖尿病周围神经病变患者胫神经[J].中国医学影像技术,2019,35(8):1142~1146 |
| 剪切波弹性成像观察糖尿病周围神经病变患者胫神经 |
| Shear wave elastography in observation on tibial nerve changes in patients with diabetic peripheral neuropathy |
| 投稿时间：2019-02-10 修订日期：2019-05-09 |
| DOI：10.13929/j.1003-3289.201902015 |
| 中文关键词: 糖尿病,2型 糖尿病神经病变 超声检查 |
| 英文关键词:diabetes mellitus,type 2 diabetic neuropathies ultrasonography |
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| 中文摘要: |
| 目的 探讨剪切波弹性成像（SWE）技术评价糖尿病周围神经病变（DPN）患者胫神经改变的价值。方法 选取30例临床诊断为2型糖尿病伴周围神经病变患者、30例2型糖尿病不伴周围神经病变患者及30名健康志愿者（对照组），应用二维超声及SWE测量并比较3组双下肢远端胫神经横截面积（CSA）及弹性模量均值（Emean）。分析2型糖尿病患者胫神经CSA、运动神经传导速度（MCV）及DPN （+）组患者疼痛视觉模拟量表（VAS）评分与Emean的相关性。绘制Emean诊断DPN的ROC曲线。结果 3组间胫神经CSA、Emean总体差异有统计学意义（P均<0.01），两两比较差异均有统计学意义（P均<0.01）。2型糖尿病患者胫神经CSA与Emean呈正相关（r=0.64，P<0.05），胫神经MCV与Emean呈负相关（r=－0.70，P<0.05）；DPN （+）组患者VAS与Emean呈正相关（r=0.82，P<0.05）。胫神经Emean诊断2型糖尿病患者DPN最佳截断值为47.4 kPa，敏感度为94.2%，特异度为80.0%。结论 2型糖尿病患者胫神经硬度增加；弹性模量值可作为诊断DPN的参考指标。 |
| 英文摘要: |
| Objective To observe the value of shear wave elastography (SWE) in evaluating changes of tibial nerve in patients with diabetic peripheral neuropathy (DPN). Methods Thirty patients of tpye 2 diabetes mellitus with DPN (DPN group), 30 patients of type 2 diabetes mellitus without DPN (DPN group) and 30 healthy control subjects (control group) were selected. The cross-sectional area (CSA) and mean nerve stiffness (Emean) of the tibial nerve in 3 groups were measured and compared with two-dimensional ultrasound and SWE. The correlation of pain visual analogue scale (VAS) with Emean in DPN (+) group as well as with tibial nerve CSA and motor nerve conduction velocity (MCV) in patients with type 2 diabetes mellitus were analyzed. ROC curve for Emean in diagnosis of DPN was drawn. Results The overall differences of tibial nerve CSA and Emean among the 3 groups were statistically significant, and the pair-wise differences were also statistically significant (all P<0.01). There was positive correlation between CSA and Emean (r=0.64, P<0.05) and negative correlation between MCV and Emean (r=-0.70, P<0.05) in patients with type 2 diabetes mellitus. There was also positive correlation between VAS and Emean (r=0.82, P<0.05) in DPN (+) group. The cutoff value of the tibial nerve Emean for diagnosis of DPN was 47.4 kPa, with sensitivity of 94.2% and specificity of 80.0%. Conclusion The tibial nerve stiffness increases in patients with type 2 diabetes. Elastic modulus can be used as a reference index for diagnosis of DPN. |
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