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High-resolution ultrasonography of the sural nerve in diabetic peripheral neuropathy

Kunwar Pal Singh
Kunwar Pal Singh
, 
Kamlesh Gupta
Kamlesh Gupta
, 
Nilanshu Kataria
Nilanshu Kataria
, 
Vijinder Arora
Vijinder Arora
 und 
Nimisha Nagpal
Nimisha Nagpal
   | 15. Juni 2020
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Article Category: research-article
Online veröffentlicht: 15. Juni 2020
Seitenbereich: 83 - 89
Eingereicht: 20. Nov. 2019
Akzeptiert: 06. März 2020
DOI: https://doi.org/10.15557/jou.2020.0013
Schlüsselwörter
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Anatomy of the sural nerve (right)(7)
Anatomy of the sural nerve (right)(7)

Fig. 2.

Ultrasonographic appearance of the normal sural nerve adjacent to the short saphenous vein in the transverse view
Ultrasonographic appearance of the normal sural nerve adjacent to the short saphenous vein in the transverse view

Fig. 3.

Ultrasonography of the left sural nerve in a non-diabetic patient showing: A. cross-sectional area of 0.027 cm2 , B. maximum thickness of nerve fascicle of 0.035 cm, and C. thickness/width ratio of 0.429. The nerve conduction studies in this patient revealed amplitude of 21.2 µV, maximum velocity of 59.34 cm/s and latency of 2.34 ms
Ultrasonography of the left sural nerve in a non-diabetic patient showing: A. cross-sectional area of 0.027 cm2 , B. maximum thickness of nerve fascicle of 0.035 cm, and C. thickness/width ratio of 0.429. The nerve conduction studies in this patient revealed amplitude of 21.2 µV, maximum velocity of 59.34 cm/s and latency of 2.34 ms

Fig. 4.

Ultrasonographic image of the right sural nerve ina diabetic patient showing: A. cross-sectional area of 0.052 cm2; B. maximum thickness of nerve fascicle of 0.037 cm, and C. thickness/width ratio of 0.555. On nerve conduction studies, the right sural nerve was found to be unstimulable
Ultrasonographic image of the right sural nerve ina diabetic patient showing: A. cross-sectional area of 0.052 cm2; B. maximum thickness of nerve fascicle of 0.037 cm, and C. thickness/width ratio of 0.555. On nerve conduction studies, the right sural nerve was found to be unstimulable

Comparison between various ultrasonographic parameters and nerve conduction study parameters in the right and left sural nerves in the controls

Findings Right p-value t-value Left p-value t-value
Mean SD Mean SD
CSA (cm2) 0.030 0.010 0.030 0.010
Amplitude (µV) 23.660 5.090 0.001 –47.65 23.780 5.120 0.001 –48.01
Latency (ms) 2.070 0.430 0.001 –55.20 2.070 0.430 0.001 –57.38
Velocity (cm/s) 54.830 12.340 0.001 –40.73 54.960 12.090 0.001 –43.28
MTNF (cm) 0.043 0.010 0.040 0.009
Amplitude (µV) 23.660 5.090 0.001 –47.67 23.780 5.120 0.001 –47.96
Latency (ms) 2.070 0.430 0.001 –54.99 2.070 0.430 0.001 –57.43
Velocity (cm/s) 54.830 12.340 0.001 –40.73 54.960 12.090 0.001 –43.24
T/W ratio 0.571 0.047 0.530 0.151
Amplitude (µV) 23.660 5.090 0.001 –46.76 23.780 5.120 0.001 –47.30
Latency (ms) 2.070 0.430 0.001 –42.86 2.070 0.430 0.001 –35.30
Velocity (cm/s) 54.830 12.340 0.001 –40.32 54.960 12.090 0.001 –42.67
SD – standard deviation

Comparison between various ultrasonographic parameters and nerve conduction study parameters in the right and left sural nerves in the cases

Findings Right p-value t-value Left p-value t-value
Mean SD Mean SD
CSA (cm2) 0.034 0.010 0.035 0.010
Amplitude (µV) 22.686 6.866 0.001 –26.36 23.350 6.973 0.001 –28.31
Latency (ms) 2.194 0.682 0.001 –23.28 2.184 0.624 0.001 –36.46
Velocity (cm/s) 41.010 11.581 0.001 –41.80 42.986 12.387 0.001 –34.99
MTNF (cm) 0.041 0.010 0.037 0.008
Amplitude (µV) 22.686 6.866 0.001 –26.36 23.350 6.973 0.001 –28.99
Latency (ms) 2.194 0.682 0.001 –23.32 2.184 0.624 0.001 –36.10
Velocity (cm/s) 41.010 11.581 0.001 –41.81 42.986 12.387 0.001 –34.98
T/W ratio 0.510 0.153 0.497 0.117
Amplitude (µV) 22.686 6.866 0.001 –25.46 23.350 6.973 0.001 –27.66
Latency (ms) 2.194 0.682 0.001 –15.23 2.184 0.624 0.001 –27.22
Velocity (cm/s) 41.010 11.581 0.001 –41.25 42.986 12.387 0.001 –34.51
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