Related Experiment Video
Updated: Feb 2, 2026
Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
Published on: October 7, 2021
Diagnostic performance of two-dimensional shear wave elastography for evaluating tibial nerve stiffness in patients
Weixi Jiang1, Sirun Huang1, Hua Teng1
1Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.
Objectives:
To evaluate the stiffness of the tibial nerve with two-dimensional shear wave elastography (2D-SWE) and to determine whether 2D-SWE can be used to diagnose diabetic peripheral neuropathy (DPN).
Methods:
The study included 70 consecutive diabetic patients with DPN or without DPN and 20 healthy volunteers. The tibial nerve stiffness measured with 2D-SWE was studied. The differences in stiffness values among patients with DPN, patients with clinically defined DPN, patients without DPN, and healthy volunteers based on clinical features and electrodiagnostic tests were evaluated with the Mann-Whitney U test and the Kruskal-Wallis test. Inter- and intraobserver variability was evaluated, and a receiver operator characteristic curve analysis was performed.
Results:
The tibial nerve stiffness based on mean (EMean), minimum (EMin), and maximum (EMax) shear elasticity indices was significantly higher in patients with DPN and clinically defined DPN than that in patients without DPN and control subjects (p < 0.05). The area under the curve (AUC) for the SWE measurements of EMean, EMin, and EMax was 0.846, 0.867, and 0.821, respectively. An EMin cutoff value of 45.7 kPa had a sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 74.0%, 87.6%, 6.0, and 0.3, respectively. The inter- and intraobserver agreements were excellent for the SWE measurements.
Conclusions:
Tibial nerve stiffness is significantly higher in diabetic patients with DPN and clinically defined DPN. The EMean and EMin have a good accuracy for identifying DPN. Minor degree of peripheral nerve lesions appear to might exist in patients with clinically defined DPN, not detectable by electrophysiology. 2D-SWE has a potential use for cases with clinically defined DPN and can be detected with 2D-SWE.
Key Points:
• 2D-SWE elastography is a noninvasive method that can be used to evaluate precise nerve stiffness for diagnosing DPN. • Minor degree of neurologic lesion might exist early in patients with clinically defined DPN and can be detected by 2D-SWE. • E Min and E Mean of SWE elasticity indices have better diagnostic accuracies than E Max for identifying DPN.
Related Concept Videos
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:24Peripheral Nervous System: Ganglia and Nerves
Nerves
The nerve is a bundle of axons that serves as the communication highway in the PNS. Each nerve is ensheathed in a protective layer of connective tissue called the epineurium. This outermost layer safeguards the nerve and supports the...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
02:12The Wave Nature of Light
01:27Shear Diagram
First, a free-body diagram of the beam is drawn, representing all the external forces and internal reactions acting on the beam. One can calculate the reaction forces at each support by employing the equilibrium equations of force and moment. The vertical component...