Premium
Sonographic assessment of nerve blood flow in diabetic neuropathy
Author(s) -
Borire A. A.,
Issar T.,
Kwai N. C.,
Visser L. H.,
Simon N. G.,
Poynten A. M.,
Kiernan M. C.,
Krishnan A. V.
Publication year - 2020
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14085
Subject(s) - medicine , diabetic neuropathy , blood flow , diabetes mellitus , peripheral neuropathy , hypervascularity , ultrasound , type 1 diabetes , median nerve , laser doppler velocimetry , tibial nerve , surgery , pathology , radiology , endocrinology , stimulation
Aims To undertake sonographic assessment of nerve blood flow in people with Type 2 diabetes and correlate the findings with neuropathy severity scores and electrophysiological measurements. Methods Median and tibial nerve ultrasound scans were undertaken in 75 people with diabetes and 30 aged‐matched controls without diabetes, using a high‐resolution linear probe at non‐entrapment sites. Nerve blood flow was quantified using power Doppler techniques to obtain the vessel score and the maximum perfusion intensity. Neuropathy severity was assessed using a total neuropathy score. Results Diabetic nerves had higher rates of nerve blood flow detection (28%) compared to the control group ( P < 0.0001). Significant correlations were found between nerve blood flow measurements and nerve size ( P <0.001), reported sensory symptoms ( P < 0.05) and neuropathy severity scores ( P < 0.001). The cohort with diabetes had significantly larger median (8.5 ± 0.3 mm 2 vs 7.2 ± 0.1 mm 2 ; P < 0.05) and tibial nerves (18.0 ± 0.9 mm 2 vs 12.8 ± 0.5 mm 2 ; P < 0.05) compared with controls. Conclusion Peripheral nerve hypervascularity is detectable by ultrasonography in moderate to severe diabetic neuropathy with prominent sensory dysfunction.