ABSTRACT
Objective:To explore the value of shear wave elastography (SWE) for diagnosis of sural neuropathy in patients with type 2 diabetes mellitus (T2DM). Methods:From September to December, 2017, 119 patients with T2DM were divided into diabetic peripheral neuropathy (DPN) group (n = 61) and non-DPN group (n = 58) according to the diagnosic criteria. In the same period, other 60 healthy volunteers were also recruited as normal group. They were measured the thickness, width, circumference and cross-sectional area of sural nerve, as well as the Young's modulus and shear wave velocity (SWV) with SWE. Based on the results of electrophysiology, the receiver operating characteristic (ROC) curve was drawn to determine the cut-off of the Young's modulus and SWV to differentiate DPN from non-DPN, and their area under the curve was compared. Results:The thickness of sural nerve was more in DPN group than in the normal group (P < 0.05). There were significant differences among all the groups in width, cross-sectional area, circumference, Young's modulus and SWV of sural nerves (P < 0.05). For SWE image, it was yellow-green for DPN group, dark blue for non-DPN group, and uniform light blue for the normal group. The cut-off was 51.65 kPa for Young's modulus, with the area under the curve of 0.925, sensitivity of 86.9% and specificity of 89.7%; while it was 4.15 m/s for SWV, with the area under curve of 0.923, specificity of 89.7% and sensitivity of 85.2%. The diagnostic efficiency for DPN was similar between Young's modulus and SWV (Z = 0.556, P = 0.579). Conclusion:SWE can provide useful information for clinical diagnosis of sural neuropathy after T2DM.
ABSTRACT
@#【Objectives】 To comparatively analyze the diagnostic performance of transrectal real- time elastography（TRTE）and magnetic resonance diffusion- weighted imaging （DWI）in differentiating benign from malignant prostatic lesions，to evaluate the value of the two methods in guided prostate biopsy，and to investigate the correlation between the two methods and Gleason scores. 【Methods】 A total of 126 patients with suspected prostate cancer underwent prostate biopsy. Preoperative tests of TRTE and DWI were performed in all of the included patients. Combined with pathological results，the diagnostic efficacy of TRTE and DWI for prostate cancer and the effects of prostate biopsy guided by the two methods were compared ，and the relationship between the elastography score and ADC value and Gleason scores were also evaluated.【Results】 The sensitivity，specificity，accuracy of diagnosing prostate cancer by TRTE were 78.8% ，78.3% ，78.6% ，the sensitivity，specificity，accuracy of diagnosing prostate cancer by DWI were 87.9% ，90% ，88.9% ， there was no significant difference of sensitivity and specificity between the two groups（P > 0.05），and the accuracy was statistically different（P < 0.05）. The AUC of elastography score and ADC value were 0.859 and 0.906，the accuracy of the diagnosis of benign and malignant prostate lesions by ADC value method was higher than elastography score ，but there was no statistically significant difference （P > 0.05）. A significant positive correlation was found between elastography score and Gleason scores，while a significant negative correlation was found between ADC value and Gleason scores.【Conclusions】TRTE and DWI is valuable in diagnosis of prostatic lesions. Biopsy guided by the two methods can improve the detection rate of prostate cancer and can provide indicative evidence for tumor differentiation analysis.