关键词: 超声, 剪切波弹性成像, 周围神经病变, 糖尿病, 正中神经

Abstract: Objective To evaluate the application of shear wave elastography (SWE) in the diagnosis of peripheral neuropathy in patients with diabetes. Methods Totally 85 patients with type 2 diabetes (T2DM) were selected from the Chengdu Office Hospital of People's Government of Tibetan Autonomous Region, including 46 patients with peripheral neuropathy (DPN) and 39 patients without peripheral neuropathy (NDPN). Compared for clinical data (gender, age, disease duration), cross-sectional area of the median nerve measured by high-frequency ultrasound (CSA) and shear wave elastography (SWE) parameters (mean Young's modulus value, Emean) and shear wave velocity (SWV) between two groups of patients. Multifactor Logistic regression analysis was carried out on the indicators between the above groups to screen independent predictors in the diagnosis of peripheral neuropathy in diabetes patients, and a combined model was constructed. The area under the operating characteristic curve(AUC), sensitivity and specificity of the subjects were used to evaluate the diagnostic efficacy of the single model and combined model of the quantitative parameters (CSA, Emean, SWV) measured by clinical data, high-frequency ultrasound and SWE in the diagnosis of peripheral neuropathy in diabetes patients. Results Age, course of disease, Emean, SWV and CSA were statistically significant in the diagnosis of peripheral neuropathy in diabetes patients(all P＜0.05). AUC was 0.658, 0.754, 0.839, 0.822 and 0.736, respectively. The combination model based on disease course, CSA and SWV showed the highest diagnostic efficiency, with AUC, sensitivity, and specificity of 0.887(0.800-0.946), 80.43%, and 84.62%, respectively. Conclusions The combined model based on the course of disease, CSA and SWV have a high diagnostic efficiency in peripheral neuropathy of diabetes patients, and has good clinical application value.

Key words: ultrasound, shear wave elastography, peripheral neuropathy, diabetes, median nerve