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Application value of strain elastography and shear wave elastography in patients with type 2 diabetic peripheral
Siqi Zheng1, Miao Zhu1, Gaoxiang Fan1
1Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
Objective:
To evaluate the value of conventional ultrasound (US), strain elastography (SE), and shear wave elastography (SWE) in detecting diabetic peripheral neuropathy (DPN) of the tibial nerve (TN), and to establish a predictive model for the diagnosis of DPN.
Methods:
A total of 32 healthy participants, 34 diabetic patients without DPN, and 36 diabetic patients with DPN were recruited for this study. The TN at the ankle and popliteal fossa were selected for examination. US was used to measure the cross-sectional area (CSA) and perimeter of the TN. Additionally, SE was used to measure the strain ratio (SR) between the TN and the surrounding adipose tissue, and SWE was used to measure the shear wave velocity (SWV) of the TN.
Results:
The CSA, perimeter, SR, and SWV of the TN at the ankle were significantly higher in the DPN group compared to both the Non-DPN group and control group (P < .05). Similarly, the TN at the popliteal fossa showed these differences. At the ankle, the CSA, perimeter, SR, and SWV of the TN in patients without DPN were significantly higher than those in the control group (P < .05). At the popliteal fossa, the SR and SWV of the TN in patients without DPN were significantly higher than those in the control group (P < .05). However, the CSA and perimeter of the TN in patients without DPN did not show a statistically significant difference compared to the control group. The area under the curve (AUC) for the diagnosis of DPN using SWE is significantly greater than that of SE and US.
Conclusion:
US, SE, and SWE could be used to diagnose DPN, and they also have good diagnostic value for sub-clinical DPN. Among these methods, SWE has demonstrated superior diagnostic efficacy. Compared to examining the TN in the popliteal fossa, the ankle level offers a better site for examination.
Advances In Knowledge:
For diabetic peripheral neuropathy, US, SE, and SWE are all promising diagnostic methods with high clinical utility.
