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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:727-734 • 0278-4297

Sonographic Evaluation of the Median Nerve in Diabetic Patients

Comparison With Nerve Conduction Studies

Tsuneo Watanabe, MT, Hiroyasu Ito, MD, PhD, Ayako Morita, MT, Yuriko Uno, MT, Takashi Nishimura, MT, Harumi Kawase, PhD, Yoshihiro Kato, MD, PhD, Toshio Matsuoka, PhD, Jun Takeda, MD, PhD and Mitsuru Seishima, MD, PhD

Clinical Laboratory Section, Gifu University Hospital, Gifu, Japan (T.W., A.M., Y.U., T.N., H.K.); and Department of Sports Medicine and Sports Science (T.W., Y.K., T.M.), Division of Molecule and Structure Research, Field of Medical Sciences (J.T.), and Department of Informative Clinical Medicine (H.I., M.S.), Gifu University Graduate School of Medicine, Gifu, Japan.

Address correspondence to Hiroyasu Ito, MD, PhD, Department of Informative Clinical Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. E-mail: hito{at}gifu-u.ac.jp

Objective. Diabetes mellitus is becoming a major cause of premature disability in Japan, and peripheral neuropathy is a common complication of diabetes. The aim of this study was to evaluate the relationship between the results of nerve conduction studies (NCS) and the size of the nerve determined by sonography in diabetic patients. Methods. Twenty diabetic patients (mean age ± SD, 57.1 ± 13.6 years) and 20 healthy volunteers (mean, 61.1 ± 8.9 years) were enrolled in this study. Patients’ wrists that had symptoms of carpal tunnel syndrome were not included in the study; those that were included had negative Phalen test results. We then divided the patients into 2 groups (patients with and without diabetic symmetric polyneuropathy [DPN]). The cross-sectional area (CSA) was measured in the carpal tunnel 5 cm proximal to the wrist and elbow joint of the median nerve. Results. There was a significant increase in the CSA in patients with DPN in the carpal tunnel compared with the control participants (P < .01) and patients without DPN (P < .01). The CSA in the carpal tunnel showed a significant correlation with the motor nerve conduction velocity (r = –0.473). Conclusions. The CSA of the median nerve in the carpal tunnel of patients with DPN is greater than that in patients without DPN and healthy individuals and correlates with NCS.

Key Words: cross-sectional area • diabetes mellitus • median nerve measurement • neuropathy • sonography

Abbreviations: CSA, cross-sectional area • CTS, carpal tunnel syndrome • DPN, diabetic symmetric polyneuropathy • MCV, motor nerve conduction velocity • NCS, nerve conduction studies

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.