Radiology Cover Article (January 2026): 10-μm-Scale Super-Resolution Ultrasound of Tibial Nerve Microcirculation in Diabetes

Cover article published in Radiology, highlighting clinical super-resolution ultrasound imaging of peripheral nerve microcirculation.

Clinical background

Diabetic peripheral neuropathy is a common and disabling complication of diabetes. Early microvascular alterations within peripheral nerves are believed to play a critical role in disease onset and progression. However, these microcirculatory changes remain difficult to assess noninvasively in clinical practice.

Conventional ultrasound primarily provides structural and limited micro-vessel information and has limited capability to visualize or quantify microcirculation within peripheral nerves, leaving an important gap between early pathophysiological changes and clinical imaging assessment.

Imaging approach and study overview

In a recent clinical study led by Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, researchers applied super-resolution ultrasound imaging to directly visualize and quantify peripheral nerve microcirculation in adult patients with diabetes.

The study was performed on the VINNO ULTIMUS 9 ultrasound system, and the U5-15L linear array probe, the technology captures radiofrequency data at a frame rate of 100 Hz, ensuring even the most minute blood flow dynamics are recorded. Using the built-in Ultra-Resolution Microscopy (URM) quantitative analysis software to implement super-resolution ultrasound (SRUS). This approach enabled 10 μm–scale in vivo visualization of tibial nerve microvasculature, allowing detailed assessment of microvascular density, spatial distribution, and remodeling beyond the capabilities of conventional ultrasound.

The research involves 100 participants who are divided into 3 groups:

1. Group I: Diabetic peripheral neuropathy (DPN) with ulcers

2. Group II: Type 2 diabetes without DPN

3. Group III: Healthy controls

Superresolution US images the endogenous blood supply system of the normal tibial nerve in 10-μm scale resolution. Image courtesy of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; from a study published in Radiology.

Key Findings & Quantitative Breakthroughs

The results revealed significant microvascular remodeling in diabetic patients:

Clinical significance

By making peripheral nerve microcirculation directly observable and quantifiable in vivo, this study provides new insight into the microvascular mechanisms underlying diabetic peripheral neuropathy.

The ability to detect and characterize subtle microvascular alterations may help:

1. earlier detection of peripheral nerve involvement

2. improved understanding of disease progression

3. noninvasive evaluation of treatment response

These findings suggest a shift from purely structural assessment toward functional and microcirculatory evaluation, offering a new imaging pathway for peripheral nerve research and clinical studies.

Academic milestone

Full article: Evaluation of Tibial Nerve Microcirculation in Diabetes Mellitus at Superresolution US: Radiology. 2026 Jan;318(1):e250347. https://doi.org/10.1148/radiol.250347

This work was published as a cover article in Radiology, one of the most influential journals in medical imaging. The publication highlights the growing clinical relevance of super-resolution ultrasound and reflects how advanced ultrasound platforms can support high-quality, disease-oriented clinical research.

Looking forward

This Radiology cover article underscores the potential of super-resolution ultrasound as a potentially practical imaging tool for studying peripheral nerve microcirculation and related microvascular disorders. It also highlights the role of URM as an enabling research platform for investigator-initiated clinical studies across multiple disease domains.