Value of shear wave elastography in the early diagnosis of DPN in patients with type 2 diabetes mellitus

Zhang Yanji; Tang Mingyuan; Jian Yang; Wu Xiuping; Ma Lihong; Cai Silang; Deng Chengliang; Wei Zairong

doi:10.3760/cma.j.cn501225-20241230-00513

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > > Accepted Manuscript

Zhang Yanji,Tang Mingyuan,Jian Yang,et al.Value of shear wave elastography in the early diagnosis of DPN in patients with type 2 diabetes mellitus[J].Chin J Burns Wounds,2026,42(7):1-10.DOI: 10.3760/cma.j.cn501225-20241230-00513.

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Value of shear wave elastography in the early diagnosis of DPN in patients with type 2 diabetes mellitus

doi: 10.3760/cma.j.cn501225-20241230-00513

1.
Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
2.
Department of Ultrasound, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
3.
Department of Emergency, Kweichow Moutai Hospital, Zunyi 564512, China
4.
Department of Medical Education, Kweichow Moutai Hospital, Zunyi 564512, China

Funds:

Collaborative Innovation Center of Chinese Ministry of Education 2020-39

Regional Science Fund Project of National Natural Science Foundation of China 8236090280

Scientific Research and Talent Development Fund of Kweichow Moutai Hospital mtyk2022-13

More Information

Corresponding author: Wei Zairong, Email: zairongwei@163.com
Received Date: 2024-12-30
Available Online: 2026-06-29

Abstract

Abstract

Objective To investigate the value of shear wave elastography (SWE) in the early diagnosis of diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus. Methods This study was a diagnostic case-control study. From May 2021 to October 2022, 68 patients with type 2 diabetes mellitus who met the inclusion criteria were admitted to the Affiliated Hospital of Zunyi Medical University, including 45 males and 23 females, aged (57±10) years. According to the presence or absence of DPN, the patients were divided into DPN group (38 patients) and non-DPN group (30 patients). During the same period, 30 healthy volunteers who underwent physical examinations at the health examination center of the hospital were recruited as healthy control group, including 19 males and 11 females, aged (56±10) years. Cross-sectional areas of the bilateral common peroneal nerves and tibial nerves measured using a color Doppler ultrasonography system in two-dimensional ultrasonography mode, and the stiffness of the bilateral common peroneal nerves and tibial nerves measured in SWE mode were compared among volunteers in healthy control group and two groups of patients at admission. Independent risk factors for the development of DPN were screened among the participants in the three groups. Among the two groups of patients, receiver operating characteristic curves were used to evaluate the diagnostic value of common peroneal nerve stiffness, common peroneal nerve cross-sectional area, tibial nerve stiffness, and tibial nerve cross-sectional area for DPN. The correlations of common peroneal nerve stiffness and common peroneal nerve cross-sectional area with the Toronto clinical scoring system (TCSS) score were analyzed in DPN group of patients. Results At admission, the cross-sectional areas of the bilateral common peroneal nerves of patients in DPN group were significantly larger than those of patients in non-DPN group and volunteers in healthy control group (P<0.05); the cross-sectional area of the right tibial nerve of patients was also significantly greater in DPN group than in non-DPN group (P<0.05). The stiffness of the bilateral tibial nerves and common peroneal nerves of patients in both non-DPN group and DPN group was significantly greater than that of volunteers in healthy control group (P<0.05). The stiffness of the left tibial nerve and the bilateral common peroneal nerves of patients was significantly greater in DPN group than in non-DPN group (P<0.05). The results of multivariable ordinal logistic regression analysis showed that common peroneal nerve stiffness, tibial nerve stiffness, and common peroneal nerve cross-sectional area were independent risk factors for the development of DPN among the participants in the three groups (with OR of 0.91, 0.93, and 0.75, respectively, 95%CI of 0.89 to 0.95, 0.89 to 0.97, and 0.58 to 0.96, respectively, P<0.05). Among the two groups of patients, common peroneal nerve stiffness yielded the largest area under the curve for diagnosing DPN, which was 0.85 (with 95%CI of 0.74 to 0.92). The optimal cutoff value was 75.29 kPa, with a sensitivity of 76.32% and a specificity of 90.00% at the optimal cutoff value. In DPN group, common peroneal nerve stiffness and common peroneal nerve cross-sectional area of patients were significantly positively correlated with the TCSS score (with r_s values of 0.83 and 0.89, respectively, P<0.05). Conclusions SWE performs well in assessing peripheral nerve stiffness in patients with type 2 diabetes mellitus. In particular, common peroneal nerve stiffness measured using SWE has relatively high diagnostic value for complication of DPN in patients and is correlated with clinical severity. It may serve as an auxiliary imaging marker for the early screening and severity assessment of DPN.
- Diabetes mellitus,
- Tibial nerve,
- Diagnosis,
- Shear wave elastography,
- Common peroneal nerve,
- Nerve stiffness,
- Nerve cross-sectional area

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References(37)

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