Aims and objectives
Early and accurate diagnosis of such a terrible complication of diabetes mellitus as the development of peripheral polyneuropathy is very important from medical,
social and economic point of view.
Diabetic polyneuropathy diagnostics is based primarily on characteristic symptoms and is confirmed by nerve conduction studies,
which take a long time and is relatively invasive procedures.
Modern methods of ultrasound examination of the peripheral nerves,
due to the speed of implementation,
noninvasive,
the complete absence of contraindications and ionizing radiation,
significantly expand therapeutic and diagnostic capabilities...
Methods and materials
Ultrasound examination of the peripheral nerves of the lower extremities was performed in 30 children aged 5-17 years,
suffering from type 1 diabetes mellitus for different periods: 0-4 years (group 1) – 9 children; 5-10 years (group 2) – 18 children; 11 years and more (group 3) — 3 children.
For quantitative analysis and comparison of nerve size with the age norm,
the groups were divided into subgroups depending on the age of children: "A" – 5-7 years,
"B" – 8-10 years,
"C" – 11-13...
Results
The results of ultrasound examination revealed significant (p≤0.05) increase in the cross-sectional area and thickness (compared with the age norm,
Fig.1) of the sciatic nerve at the gluteal fold lower in the 1D group 56% (Fig.2),
in group 2C - 27%,
2D - 30%,
3D group 16%; tibial nerve at the popliteal fossa (compared with the age norm,
Fig.3)in group 2C to 33%,
in the 3D group 76% (Fig.4); common peroneal nerve at the popliteal fossa(compared with the age norm,
Fig.5)in a group 3D 75%...
Conclusion
The results of the ultrasound study demonstrate the possibility of assessing quantitative and qualitative changes in the peripheral nerve trunks of the lower extremities in children with long-term type 1 diabetes mellitus with the development of diabetic peripheral polyneuropathy.
Ultrasonic method of diagnosis can be an additional method of monitoring changes in peripheral nerves in patients with this pathology.
Personal information
Saltykova Victoria Gennadievna,
MD,
PhD,
Russian Medical Academy of Postgraduate Education of Ministry of Health of Russian Federation,
Moscow
Department of ultrasound diagnostics
Nov.
Ipatovka str.,
4,Moscow,Russian Federation,127299
Phone: +7(499)150-90-61.
Fax: +7(926)200-75-81
E-mail:
[email protected]
Danilova M.G.
– MD,
Ultrasound Diagnostics Department,
Clinical Diagnostic Center «Zdorovie»,
Rostov-on-Don,Russian Federation
References
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Katsalouli M.,
& Karavanaki K.
(2012).
Peripheral neuropathy in children with type 1 diabetes.
Diabetes & Metabolism,
38(4),
281–289
2.Kang,
S.,
et al.,
Sonographic features of peripheral nerves at multiple sites in patients with diabetic polyneuropathy,
Journal of Diabetes and Its Complications (2015),
http://dx.doi.org/10.1016/j.jdiacomp.2015.12.008
3.Lee D.,
& Dauphinee D.M.
(2005).Morphological and functional changes in the diabetic peripheral nerve: Using diagnostic ultrasound and neurosensory testing to select candidates for nerve decompression.
Journal of the American Podiatric Medical Association,
95(5),
433–437....