Papanas N, Courcoutsakis N, Papatheodorou K, Daskalogiannakis G, Maltezos E, Prassopoulos P
Outpatient Clinic of Diabetic Foot at Second Department of Internal Medicine, Democritus University of Thrace, Greece.
Exp Clin Endocrinol Diabetes. 2009 Nov;117(10):645-8. doi: 10.1055/s-0029-1224121. Epub 2009 Oct 15.
The aim of this study was to evaluate Achilles tendon (AT) in type 2 diabetic patients with vs. without peripheral neuropathy using Magnetic Resonance Imaging (MRI). The study included 19 patients (group A, mean age 63.9+/-7.4 years) with peripheral neuropathy and 19 patients (group B, mean age 63.6+/-6.1 years) without peripheral neuropathy, as well as 16 healthy controls (group C, mean age 61.6+/-8.4 years). Neuropathy was diagnosed by the Diabetic Neuropathy Index (DNI). The maximum AT thickness and AT volume were measured on sagittal T (1) weighted MRI images. AT volume was calculated by the sum of the tendon surface area of all contiguous sections multiplied by the slice thickness. Diabetic patients had significantly (p<0.001) greater AT volume than controls (9742.0+/-2034.9 mm(3) vs. 7323.8+/-1918.2 mm(3)). This difference was observed both in men (p=0.030) and in women (p<0.001). AT volume was significantly greater in group A vs. C (p=0.003) and in group B vs. C (p<0.001), but there was no difference between groups A and B (p=0.469). Finally, in group A increased AT volume was significantly (p=0.041) associated with clinical severity of neuropathy. CONCLUSIONS Type 2 diabetic patients have increased AT volume as compared to controls. There is no difference in AT volume between patients with and without neuropathy. However, in neuropathic patients increased AT volume is associated with severity of neuropathy.
本研究旨在利用磁共振成像（MRI）评估2型糖尿病伴或不伴周围神经病变患者的跟腱（AT）情况。该研究纳入了19例周围神经病变患者（A组，平均年龄63.9±7.4岁）、19例无周围神经病变患者（B组，平均年龄63.6±6.1岁）以及16例健康对照者（C组，平均年龄61.6±8.4岁）。通过糖尿病神经病变指数（DNI）诊断神经病变。在矢状面T1加权MRI图像上测量跟腱最大厚度和跟腱体积。跟腱体积通过所有连续层面的肌腱表面积之和乘以层面厚度来计算。糖尿病患者的跟腱体积显著大于对照组（p<0.001）（9742.0±2034.9mm³ vs. 7323.8±1918.2mm³）。男性（p=0.030）和女性（p<0.001）中均观察到这种差异。A组与C组相比（p=0.003）以及B组与C组相比（p<0.001），跟腱体积显著更大，但A组和B组之间无差异（p=0.469）。最后，在A组中，跟腱体积增加与神经病变的临床严重程度显著相关（p=0.041）。结论：与对照组相比，2型糖尿病患者的跟腱体积增加。有神经病变和无神经病变的患者在跟腱体积上无差异。然而，在神经病变患者中，跟腱体积增加与神经病变的严重程度相关。
