Abstract: Objective  To observe the abnormalities of femoral and saphenous nerves in patients of type 2 diabetes mellitus (T2DM) with or without diabetic periphery neuropathy (DPN) by high-frequency ultrasonography.  Methods  Eighty-one T2DM patients were enrolled and divided into 2 groups: group B (T2DM without DPN, N = 40), group C (T2DM with DPN, N = 41). Forty-two healthy subjects were enrolled as control group (group A). LOGIQ-E9 color Doppler ultrasound instrument was used. Between inguinal ligment and inguinal fold, the femoral nerve was slightly hyperechoic with reticular structure near by the femoral artery on transverse section. In the inner thigh, the saphenous nerve was slightly hyperechoic with reticular structure along with adductor canal on transverse section. The internal echo and succession of the two nerves in 3 groups were observed. The width, thickness and cross-sectional areas of the two nerves were measured and compared.  Results  In group A, the internal echo of the two nerves appeared as slightly hyperechoic with reticular structure on transverse section, and strips of hypoechogenicity and parallel structure of slightly hyperechogenicity on longitudinal section. Compared with group A, the internal echo of group B was decreased slightly, and the reticular structure was slightly obscure and strips of echo on longitudinal section were less clear; while the internal echo of group C was decreased obviously, the reticular structure was not clear and strips of echo on longitudinal section were obscure. Compared with group A, both the width (P = 0.000, for all), thickness (P = 0.023, 0.036) and cross-sectional area (P = 0.000, for all) of femoral nerve and the width (P = 0.010, 0.014), thickness (P = 0.001, for all) and cross-sectional area (P = 0.002, 0.004) of saphenous nerve in group B and C were increased. Besides, compared with group B, thickness (P = 0.048, 0.012) and cross-sectional area (P = 0.031, 0.034) of femoral and saphenous nerves in group C were increased.  Conclusions  The abnormalities of internal echo and measurement of the trunk of femoral and saphenous nerves in patients of T2DM with or without DPN can be displayed clearly by high-frequency ultrasonography. It can provide objective basis for clinical diagnosis with great significance.

Key words: Diabetes mellitus, type 2, Diabetic neuropathies, Peripheral nervous system diseases, Ultrasonography, Doppler, color

摘要： 目的 探讨高频超声用于评价2 型糖尿病合并周围神经病变患者下肢股神经和隐神经异常改变的临床价值。方法 共81 例2 型糖尿病患者分为无周围神经病变组（40 例）和合并周围神经病变组（41 例），通过彩色多普勒超声观察股神经和隐神经内部回声及连续性，测量并比较神经宽径、厚径和横截面积。结果 正常对照组受试者股神经和隐神经横切面扫描呈略高回声，内部呈细小筛网格状，纵切面扫描内部呈条状低回声和平行线样排列的条状略高回声；无周围神经病变组患者内部回声略减低，细小筛网格状结构模糊，纵切面条状低回声结构欠清晰；合并周围神经病变组患者内部回声明显减低，细小筛网格状结构显示不清，纵切面条状低回声结构模糊。与正常对照组相比，糖尿病组患者股神经宽径（均P = 0.000）、厚径（P = 0.023，0.036）和横截面积（均P = 0.000）增大；隐神经宽径（P = 0.010，0.014）、厚径（均P = 0.001）和横截面积（P = 0.002，0.004）增大；合并周围神经病变组患者股神经和隐神经厚径（P = 0.048，0.012）和横截面积（P = 0.031，0.034）较无周围神经病变组增大。结论 高频超声可以清晰地显示2 型糖尿病合并周围神经病变患者股神经和隐神经主干内部回声及各径线的异常改变，为临床诊断提供客观依据，具有重要临床意义。

关键词: 糖尿病, 2型, 糖尿病神经病变, 周围神经系统疾病, 超声检查, 多普勒, 彩色