ARFI Imaging Technology Evaluate The Clinical Value Of Tibial Nerve Hardness In Diabetic Peripheral Neuropathy

Part Ⅰ Study on ARFI Imaging measurement method for diabetic peripheral neuropathyObjective:To explore the selection of cross section during measurement of tibial nerve elasticity by ultrasonic radiation force pulse imaging,as a follow-up study of ARFI imaging in the application of diabetic tibial neuropathy.Methods:The mean values of transverse section elasticity and longitudinal section elasticity of left tibial nerve of 60 patients diagnosed with diabetic peripheral neuropathy and 60 patients in the control group were measured respectively,and the difference was analyzed to see whether there was statistical significance.Results:The mean longitudinal elasticity of tibial nerve in the 60 cases of DPN group was 2.84±0.60 m/s,and the mean longitudinal elasticity of tibial nerve in the 60 cases of control group was 2.67±0.54 m/s,the difference was not statistically significant(P>0.05).The mean cross section elasticity of tibial nerve in 60 cases of DPN group was 1.12±0.27 m/s,and the mean cross section elasticity of tibial nerve in 60 cases of control group was 0.97±0.18 m/s,with significant statistical difference(P<0.01).Conclusions:The acoustic palpation tissue quantification technique of ultrasonic radiation force pulse imaging can provide a quantitative value of tibial nerve hardness,and the tibial nerve elasticity value measured in cross section is statistically significant.The elastic value of tibial nerve in DPN group was higher than that in control group.Part Ⅱ Clinical application of ARFI imaging in the evaluation of diabetic peripheral neuropathyObjective:The VTQ using ARFI imaging technology,get diabetes peripheral neuropathy group and the control group and without peripheral neuropathy of diabetes group of tibial transverse elastic average,by comparing the three groups of elasticity,calculate whether diabetes or tibial elastic best cutoff value of DPN,found the VTQ ARFI imaging technology in diabetes shank application value in early diagnosis of neuropathy.Methods:The mean cross-sectional elasticity of left tibial nerve was measured in 60 patients diagnosed with diabetic peripheral neuropathy,60 patients without diabetic peripheral neuropathy and 60 patients in the control group.ROC curves of DPN group and control group,diabetes group and control group were drawn respectively to obtain the area under the curve and the optimal cut-off value,and the sensitivity and specificity of the two groups were compared.Results:The left tibial nerve elasticity of 60 patients with diabetes and peripheral neuropathy was 1.14±0.28m/s;which was higher than that of 60 patients in the control group(0.97±0.18 m/s).ROC curve was plotted,the area under the curve was 0.725(P<0.001),the optimal cut-off value was 0.98,the sensitivity was 0.70,and the specificity was 0.71.The mean cross sectional elasticity of left tibial nerve in 60 diabetic patients without peripheral neuropathy was 1.05±0.24m/s,higher than that in 60 control patients,but lower than that in diabetic patients with peripheral neuropathy.ROC curve was drawn between the elasticity of tibial nerve in 120 patients with diabetes and the elasticity of 60 patients in the control group.The area under the curve was 0.659(P<0.001),and the optimal cut-off value was 0.98 m/s,with a sensitivity of 0.61 and specificity of 0.71.The VTQ technique of ARFI imaging is used to determine whether diabetic patients have peripheral neuropathy.The optimal cut-off value is 0.98m/s,with general specificity and sensitivity.Conclusions:The VTQ technique of ARFI imaging can be used to diagnose whether diabetic patients have peripheral neuropathy,and it is also a simple and non-invasive screening method to evaluate the early pathological changes of peripheral nerve in diabetic patients.Part Ⅲ Study on the correlation between elastic value and atherosclerosis of lower extremity in diabetic peripheral neuropathyObjective:To explore the possible relationship between lower limb atherosclerosis and increased tibial nerve hardness in DPN patients by comparing the ratio of DPN patients and healthy subjects with lower limb atherosclerosis.Methods:Under the gray scale image of two-dimensional ultrasound,observe whether the lower limb arteries of all subjects are accompanied with lower limb atherosclerosis.The mean cross-sectional elasticity of left tibial nerve in 60 patients diagnosed with diabetic peripheral neuropathy and 60 healthy subjects were measured.A cross table was made,chi-square test was performed and the odds ratio was calculated to study the correlation between DPN patients and the presence or absence of lower limb atherosclerosis.Results:The incidence of lower limb atherosclerosis in DPN subjects was 26 times higher than that in healthy controls,OR value was 26.000(95%confidence interval was 9.789-69.057,p<0.001),and was positively correlated with DPN.The mean elasticity of DPN patients with lower limb atherosclerosis was 1.13±0.26 m/s,higher than that of DPN patients without lower limb atherosclerosis:1.04±0.24m/s.Conclusions:The probability of DPN patients with lower extremity atherosclerosis,significantly higher than the healthy subjects and DPN with limb atherosclerosis in patients with elastic value higher than that of patients with lower extremity atherosclerosis with DPN diabetes peripheral neuropathy and is positively correlated with lower extremity atherosclerosis,to provide clinical understanding of neural hardness change some supplementary information.