Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound
BackgroundDiabetic foot complications, driven by microvascular dysfunction, remain a leading cause of morbidity and amputations. Early detection of microcirculatory and biomechanical alterations in vulnerable muscles, such as the extensor hallucis brevis (EHB), may contribute to risk stratification....
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1639270/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850061948211691520 |
|---|---|
| author | Fuqiang Yan Mingli Cai Meirong Li Shanshan Huang Jingyi Guo Jinmiao Lin Guorong Lyu |
| author_facet | Fuqiang Yan Mingli Cai Meirong Li Shanshan Huang Jingyi Guo Jinmiao Lin Guorong Lyu |
| author_sort | Fuqiang Yan |
| collection | DOAJ |
| description | BackgroundDiabetic foot complications, driven by microvascular dysfunction, remain a leading cause of morbidity and amputations. Early detection of microcirculatory and biomechanical alterations in vulnerable muscles, such as the extensor hallucis brevis (EHB), may contribute to risk stratification. However, noninvasive tools for quantifying these changes are lacking.MethodsThis cross-sectional study enrolled 90 participants stratified into healthy controls, uncomplicated type 2 diabetes (T2DM), and T2DM with microvascular complications (MC). Shear wave elastography (SWE) measured EHB stiffness (mean Young’s modulus, Emean), while contrast-enhanced ultrasound (CEUS) assessed perfusion dynamics (transcapillary transit time [ΔAT], net enhancement intensity [ΔPI]). Diagnostic accuracy and reproducibility were evaluated via ROC analysis and intra-class correlation coefficients (ICC).ResultsEmean increased progressively across groups (control: 11.88 kPa; T2DM: 15.78 kPa; T2DM+MC: 18.57 kPa; P < 0.01). T2DM+MC exhibited prolonged ΔAT (89.5 s vs. 50.5 s in controls) and reduced ΔPI (5.0 dB vs. 7.0 dB; P < 0.01). ROC analysis demonstrated high diagnostic accuracy for ΔAT (AUC = 0.970), Emean (AUC = 0.947), and ΔPI (AUC = 0.931) in detecting MC. Both SWE and CEUS showed excellent reproducibility (ICC > 0.80).ConclusionSWE and CEUS provide robust, noninvasive biomarkers for early diabetic microvascular complications. The EHB’s unique susceptibility to stiffness and perfusion deficits highlights its clinical value, which may facilitate diabetic foot risk assessment and guide timely interventions to mitigate ulceration and amputations. |
| format | Article |
| id | doaj-art-3286d81745634498b23d00fae26685f2 |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-3286d81745634498b23d00fae26685f22025-08-20T02:50:03ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16392701639270Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasoundFuqiang Yan0Mingli Cai1Meirong Li2Shanshan Huang3Jingyi Guo4Jinmiao Lin5Guorong Lyu6Department of Ultrasound Medicine, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Ultrasound Medicine, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Endocrinology, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Ultrasound Medicine, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Ultrasound Medicine, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Ultrasound Medicine, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital), Quanzhou, ChinaDepartment of Ultrasound Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, ChinaBackgroundDiabetic foot complications, driven by microvascular dysfunction, remain a leading cause of morbidity and amputations. Early detection of microcirculatory and biomechanical alterations in vulnerable muscles, such as the extensor hallucis brevis (EHB), may contribute to risk stratification. However, noninvasive tools for quantifying these changes are lacking.MethodsThis cross-sectional study enrolled 90 participants stratified into healthy controls, uncomplicated type 2 diabetes (T2DM), and T2DM with microvascular complications (MC). Shear wave elastography (SWE) measured EHB stiffness (mean Young’s modulus, Emean), while contrast-enhanced ultrasound (CEUS) assessed perfusion dynamics (transcapillary transit time [ΔAT], net enhancement intensity [ΔPI]). Diagnostic accuracy and reproducibility were evaluated via ROC analysis and intra-class correlation coefficients (ICC).ResultsEmean increased progressively across groups (control: 11.88 kPa; T2DM: 15.78 kPa; T2DM+MC: 18.57 kPa; P < 0.01). T2DM+MC exhibited prolonged ΔAT (89.5 s vs. 50.5 s in controls) and reduced ΔPI (5.0 dB vs. 7.0 dB; P < 0.01). ROC analysis demonstrated high diagnostic accuracy for ΔAT (AUC = 0.970), Emean (AUC = 0.947), and ΔPI (AUC = 0.931) in detecting MC. Both SWE and CEUS showed excellent reproducibility (ICC > 0.80).ConclusionSWE and CEUS provide robust, noninvasive biomarkers for early diabetic microvascular complications. The EHB’s unique susceptibility to stiffness and perfusion deficits highlights its clinical value, which may facilitate diabetic foot risk assessment and guide timely interventions to mitigate ulceration and amputations.https://www.frontiersin.org/articles/10.3389/fendo.2025.1639270/fulldiabetesskeletal musclemicrocirculationelasticityultrasound diagnosis |
| spellingShingle | Fuqiang Yan Mingli Cai Meirong Li Shanshan Huang Jingyi Guo Jinmiao Lin Guorong Lyu Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound Frontiers in Endocrinology diabetes skeletal muscle microcirculation elasticity ultrasound diagnosis |
| title | Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound |
| title_full | Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound |
| title_fullStr | Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound |
| title_full_unstemmed | Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound |
| title_short | Assessment of extensor hallucis brevis stiffness and microcirculation in diabetes: shear wave elastography and contrast-enhanced ultrasound |
| title_sort | assessment of extensor hallucis brevis stiffness and microcirculation in diabetes shear wave elastography and contrast enhanced ultrasound |
| topic | diabetes skeletal muscle microcirculation elasticity ultrasound diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1639270/full |
| work_keys_str_mv | AT fuqiangyan assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT minglicai assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT meirongli assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT shanshanhuang assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT jingyiguo assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT jinmiaolin assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound AT guoronglyu assessmentofextensorhallucisbrevisstiffnessandmicrocirculationindiabetesshearwaveelastographyandcontrastenhancedultrasound |