二维超声及二维剪切波弹性成像评价2型糖尿病患者下肢周围神经病变

Two-dimensional ultrasound and two-dimensional shear wave elastography for evaluation on lower extremity peripheral neuropathy in patients with type 2 diabetes mellitus

目的:探讨应用二维超声及二维剪切波弹性成像(2D-SWE)评价2型糖尿病(T2DM)患者下肢股神经、隐神经病变的价值。方法:将60例T2DM患者依据周围神经病变(DPN)诊断标准分为30例T2DM不合并DPN组(B组)、30例T2DM合并DPN组(C组)。另选取30例健康志愿者为对照组(A组)。应用二维超声测量双下肢股神经、隐神经的宽径、厚径、横截面积(CSA)、周长;应用2D-SWE测量双下肢股神经、隐神经的平均剪切波速度(C_(mean)),比较左右下肢及组间参数差异。结果:C组股神经、隐神经的宽径、厚径、CSA、周长均大于B组及A组(P均<0.05);B组股神经的厚径、CSA均大于A组(P均<0.05)。B组隐神经的宽径、厚径、CSA、周长均大于A组(P均<0.05)。C组股神经、隐神经的C_(mean)均大于B组及A组(P均<0.05);B组股神经、隐神经C_(mean)均大于A组(P均<0.05)。结论:二维超声及2D-SWE能够无创、客观、准确地评价T2DM患者下肢股神经、隐神经的异常改变。

Objective:To explore the value of two-dimensional ultrasound and two-dimensional shear wave elastography(2D-SWE)for evaluating the lower extremity femoral nerve and saphenous neuropathy in patients with type 2 diabetes mellitus(T2DM).Methods:According to the diabetic peripheral neuropathy(DPN)diagnostic criteria,60 T2DM patients were enrolled and divided into 30 T2DM patients without DPN(group B),and 30 T2DM patients with DPN(group C).Another 30 healthy volunteers were enrolled in the control group(group A).The width,thickness,cross-sectional area(CSA),and circumference of the femoral and saphenous nerves in both lower extremities were measured with two-dimensional ultrasound.The average shear wave velocity(C_(mean))of the femoral nerve and saphenous nerve of both lower extremities was measured by 2D-SWE.Parameters of the left and right lower extremities were compared in each group,and the above parameters were compared among groups.Results:The width,thickness,CSA,and circumference of the femoral nerve and saphenous nerve in group C were greater than those in groups B and A(all P<0.05);the thickness,diameter and CSA of the femoral nerve in group B were greater than those in group A(all P<0.05).The width,thickness,CSA,and circumference of saphenous nerve in group B were greater than those in group A(all P<0.05).The C_(mean)of the femoral nerve and saphenous nerve in group C were higher than those in groups B and A(all P<0.05);the C_(mean)of femoral nerve and saphenous nerve in group B were higher than those in group A(all P<0.05).Conclusion:Two-dimensional ultrasound and 2D-SWE can be used to non-invasively,objectively and accurately evaluate the abnormal changes in the lower extremity femoral nerve and saphenous nerve in patients with T2DM.