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. 2022 Jun 23:13:899822.
doi: 10.3389/fendo.2022.899822. eCollection 2022.

Shear Wave Elastography in the Diagnosis of Peripheral Neuropathy in Patients With Chronic Kidney Disease Stage 5

Xuan Li  1 , Haoqi Sun  1 , Zhaoguang Zhang  2 , Jing Liu  3 , Huiying Xu  1 , Lin Ma  1 , Haibo Zhang  1 , Jialin Li  1 , Qian Luo  2 , Xiangming Wang  1 , Min Guo  1 , Zhentao Guo  1 , Xuexun Chen  1
Affiliations

Shear Wave Elastography in the Diagnosis of Peripheral Neuropathy in Patients With Chronic Kidney Disease Stage 5

Xuan Li et al. Front Endocrinol (Lausanne). .

Abstract

Objective: To observe the feasibility of shear wave elastography (SWE) in the diagnosis of peripheral neuropathy in patients undergoing hemodialysis [chronic kidney disease stage 5 dialysis (CKD5D)].

Methods: Forty patients with CKD5D were divided into a uremic peripheral neuropathy (UPN) group (n = 25) and a non-UPN group (n = 15) according to the results of a neuro-electrophysiological examination. Sixteen healthy control subjects were also enrolled in this study. Two-dimensional ultrasound examination was conducted, and SWE was then performed to measure Young's modulus of the tibial nerve. The left and right diameters (D1), anterior and posterior diameters (D2), perimeter (C), cross-sectional area (CSA), and Young's modulus (E) were measured three times at the same non-entrapment site. The average values were recorded and calculated. The following evaluation indices were also analyzed: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC).

Results: D1, D2, C, and CSA were not significantly different among the three groups (P > 0.05). However, the difference in the E value among the three groups was statistically significant (P < 0.05). The AUC was 0.889 based on the E value. Using a tibial nerve E value of 48.35 kPa as the cutoff value, the sensitivity, specificity, PPV, and NPV were 86.0%, 84.0%, 81.1%, and 88.1%, respectively.

Conclusions: SWE is useful for the diagnosis of peripheral neuropathy in patients with CKD5D. Young's modulus of 48.35 kPa for the tibial nerve is the optimal cutoff value and has the best diagnostic efficiency for peripheral neuropathy in CKD5D patients.

Keywords: chronic kidney disease; cutoff value; elasticity imaging techniques; peripheral neuropathy; tibial nerve.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) The left and right diameters, anterior and posterior diameters, perimeter, and CSA of the tibial nerve were measured 4 cm proximal to the medial level in a 57-year-old woman with UPN. (B) Two split US and SWE images were obtained at the same longitudinal level in a 39-year-old man with UPN. Quantitative SWE measurements showed that the mean nerve stiffness was 88.09 kPa. R, Right.
Figure 2
Figure 2
SWE image of the tibial nerve in a 52-year-old man with non-UPN. Quantitative SWE measurements showed that the mean nerve stiffness was 44.83 kPa. R, Right.
Figure 3
Figure 3
SWE image of the tibial nerve in a 56-year-old healthy man. Quantitative SWE measurements showed that the mean nerve stiffness was 28.63 kPa. R, Right.
Figure 4
Figure 4
Receiver operating characteristic curve based on SWE measurement values.
See this image and copyright information in PMC

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