摘要
目的:总结2型糖尿病合并周围神经病变的高频超声声像图特征,分析与电生理检查的相关性。方法:选取40例2型糖尿病患者,根据电生理检查分为20例糖尿病非周围神经病变组(A组),20例糖尿病周围神经病变组(B组),选取同期23例非糖尿病患者作为健康对照组(C组)。分别测量正中神经(MN)7个不同位点左右径(D1)、前后径(D2),并用公式法测量横截面积(CSA),同时观察其超声声像图变化特征。此外分析超声与电生理检查之间的相关性。结果:63例研究对象,其中男36例,女27例,平均年龄(54.32±12.08)岁。(1)与C组相比,A、B组D1、D2及CSA多增加,差异有统计学意义。B组与A组相比,D1及CSA多增大,差异有统计学意义。(2)ROC曲线分析,A、B组在MN6水平下诊断准确率最高,其最佳临界值分别为9.61 mm^2、10.65 mm^2。(3)此外,还表现为神经内部筛网状结构消失、回声减低以及部分出现血流信号、神经外膜增厚,上述超声表现在MN4、MN5、MN6水平尤为明显。(4)正中神经CSA与电生理参数之间做相关性分析,CSA与运动潜伏期呈正相关,与运动传导速度、感觉振幅、感觉传导速度呈负相关。结论:糖尿病合并周围神经病变患者正中神经主要表现为左右径、前后径及横截面积增加、内部筛网状结构消失、回声减低、神经外膜增厚以及内部出现血流信号,此外高频超声与电生理检查之间有一定的相关性,高频超声可以在一定程度上辅助早期诊断糖尿病周围神经病变。
Objective: To summarize the high-frequence ultrasound features in peripheral neuropathy(DPN) patients of type 2 diabetes, and to analyze their correlation with neural eletrophysiological examination. Methods: According to neural eletrophysiological examination, forty patients with type 2 diabetes mellitus were divided into the non-DPN group(group A, 20 cases)and DPN group(group B, 20 cases), and 23 non-diabetic patients were enrolled as the control group(group C). The diameter(D1), anteroposterior diameter(D2) and cross-sectional area(CSA) were measured in seven points of median nerve. Then, the ultrasound imaging features were observed. Moreover, the correlation between ultrasound and neural eletrophysiological examination was analyzed. Results: Sixty-three participants(36 men, 27 women, average age(54.32±12.08) years old) were enrolled.(1)Compared with group C, D1, D2 and CSA of group A and B were often increased with significant difference. Compared with group A, D1 and CSA of group B were often increased with significant difference.(2)On the basis of the receiver operating characteristic curve, the highest diagnosis value was at MN6 level, and the cutoff values of CSA were 9.61 mm^2 and 10.65 mm^2.(3)Moreover, the disappearance of screen structure, hypoechoic, thickened epineurium and increased blood flow was shown, especially at the level of MN4, MN5, MN6.(4)According to correlation analysis, CSA was positively correlated with distal motor latency and negatively correlated with motor conduction velocity, sensory conduction velocity and sensory nerve action potential amplitude. Conclusion: DPN represents with the increase of D1, D2 and CSA, the disappearance of screen structure, hypoechoic, thickened epineurium and increased blood flow. Moreover, there is some correlation between ultrasound and neural eletrophysiological examination. To some extent, high-frequence ultrasound could help diagnose DPN early.
作者
马西顺
杜丽珍
类婷婷
韩彤亮
MA Xi-shun;DU Li-zhen;LEI Ting-ting;HAN Tong-liang(Department of Ultrasond,Qingdao Municipal Hospital Affiliated Hospital of Qingdao University,Qingdao Shandong 266071,China)
出处
《中国临床医学影像杂志》
CAS
2019年第10期734-737,共4页
Journal of China Clinic Medical Imaging
关键词
糖尿病
2型
周围神经系统疾病
超声检查
多普勒
彩色
Diabetes mellitus,type 2
Peripheral nervous system diseases
Ultrasonography,Doppler,color
