TY - JOUR
T1 - Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies
T2 - a cross-sectional study
AU - Amaya, Joshua
AU - Lue, Brian
AU - Silva, Flavio Duarte
AU - Raspovic, Katherine
AU - Xi, Yin
AU - Chhabra, Avneesh
N1 - Funding Information:
Avneesh Chhabra : Consultant: ICON Medical and TREACE Medical Concepts Inc., Book Royalties: Jaypee, Wolters, Speaker: Siemens, Medical advisor, and research grant: Image biopsy Inc. Additionally, Avneesh Chhabra is a Deputy Editor of European Radiology. He has not taken part in the review or selection process of this article. Others: None.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to European Society of Radiology.
PY - 2023
Y1 - 2023
N2 - Objective: To evaluate the utility of apparent diffusion coefficient (ADC) measurements from ankle MRI diffusion-weighted imaging (DWI) studies in identifying neuropathic changes in diabetic patients. Methods: In total, 109 consecutive ankle MRI scans (n = 101 patients) at a single tertiary care county hospital from November 1, 2019, to July 11, 2021, who met the inclusion criteria were identified. Patients were divided into 2 cohorts: diabetic (n = 62) and non-diabetic (n = 39). Demographics, HgbA1c, neuropathy diagnosis, and image quality data were collected. Abductor hallucis (AH) ADC mean and minimum (min) values and posterior tibial nerve (PTN) ADC mean and minimum values were measured. Student t-test and Pearson’s correlation coefficient analysis were performed using R. Results: Diabetic patients had significantly higher mean and min ADC values (× 10−3 mm2/s) of the AH muscle (mean: 1.77 vs 1.39, p < 0.001; min: 1.51 vs 1.06, p < 0.001) and PTN (mean: 1.65 vs 1.18, p < 0.001; min: 1.33 vs 0.95, p < 0.001) compared to non-diabetic patients. HgbA1c positively correlated with AH and PTN ADC mean values (AH: p = 0.036; PTN: p = 0.004). Conclusion: Our data suggests that an increasing diffusivity of water as quantified by ADC across neuronal and muscular membranes is a consequence of the pathophysiology of the disease. Thus, ankle MRI-DWI studies are useful in identifying neuropathic changes in diabetic patients and quantifying the severity noninvasively. Key Points: •Diabetic patients had significantly higher mean and minimum ADC values of the abductor hallucis muscle and posterior tibial nerve compared to non-diabetic patients. •HgbA1c positively correlated with ADC mean values (AH: p = 0.036; PTN: p = 0.004) suggesting that an increasing diffusivity of water across neuronal and muscular membranes is a consequence of the pathophysiology of diabetic neuropathy. •Ankle MRI DWI can be used clinically to non-invasively identify neuropathic changes due to diabetes mellitus.
AB - Objective: To evaluate the utility of apparent diffusion coefficient (ADC) measurements from ankle MRI diffusion-weighted imaging (DWI) studies in identifying neuropathic changes in diabetic patients. Methods: In total, 109 consecutive ankle MRI scans (n = 101 patients) at a single tertiary care county hospital from November 1, 2019, to July 11, 2021, who met the inclusion criteria were identified. Patients were divided into 2 cohorts: diabetic (n = 62) and non-diabetic (n = 39). Demographics, HgbA1c, neuropathy diagnosis, and image quality data were collected. Abductor hallucis (AH) ADC mean and minimum (min) values and posterior tibial nerve (PTN) ADC mean and minimum values were measured. Student t-test and Pearson’s correlation coefficient analysis were performed using R. Results: Diabetic patients had significantly higher mean and min ADC values (× 10−3 mm2/s) of the AH muscle (mean: 1.77 vs 1.39, p < 0.001; min: 1.51 vs 1.06, p < 0.001) and PTN (mean: 1.65 vs 1.18, p < 0.001; min: 1.33 vs 0.95, p < 0.001) compared to non-diabetic patients. HgbA1c positively correlated with AH and PTN ADC mean values (AH: p = 0.036; PTN: p = 0.004). Conclusion: Our data suggests that an increasing diffusivity of water as quantified by ADC across neuronal and muscular membranes is a consequence of the pathophysiology of the disease. Thus, ankle MRI-DWI studies are useful in identifying neuropathic changes in diabetic patients and quantifying the severity noninvasively. Key Points: •Diabetic patients had significantly higher mean and minimum ADC values of the abductor hallucis muscle and posterior tibial nerve compared to non-diabetic patients. •HgbA1c positively correlated with ADC mean values (AH: p = 0.036; PTN: p = 0.004) suggesting that an increasing diffusivity of water across neuronal and muscular membranes is a consequence of the pathophysiology of diabetic neuropathy. •Ankle MRI DWI can be used clinically to non-invasively identify neuropathic changes due to diabetes mellitus.
KW - Diabetes mellitus
KW - Diabetic neuropathies
KW - Magnetic resonance imaging
KW - Muscles
KW - Nerves
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U2 - 10.1007/s00330-023-09466-7
DO - 10.1007/s00330-023-09466-7
M3 - Article
C2 - 36806567
AN - SCOPUS:85148371222
SN - 0938-7994
JO - European Radiology
JF - European Radiology
ER -