Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA.
Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
Eur Radiol. 2023 Jul;33(7):4855-4863. doi: 10.1007/s00330-023-09466-7. Epub 2023 Feb 18.
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.
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.
Diabetic patients had significantly higher mean and min ADC values (× 10 mm/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).
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.
• 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.
评估踝关节 MRI 弥散加权成像（DWI）中表观弥散系数（ADC）测量值在识别糖尿病患者神经病变中的效用。
本研究回顾性分析了 2019 年 11 月 1 日至 2021 年 7 月 11 日在一家三级护理县医院进行的 109 例连续踝关节 MRI 扫描（n=101 例患者），这些患者符合纳入标准。将患者分为 2 组：糖尿病组（n=62）和非糖尿病组（n=39）。收集患者的人口统计学、糖化血红蛋白（HgbA1c）、神经病变诊断和图像质量数据。测量拇展肌（AH）的 ADC 平均值和最小值（min）值和胫后神经（PTN）的 ADC 平均值和最小值。使用 R 进行学生 t 检验和 Pearson 相关系数分析。
与非糖尿病患者相比，糖尿病患者的 AH 肌肉（平均值：1.77 比 1.39，p<0.001；最小值：1.51 比 1.06，p<0.001）和 PTN（平均值：1.65 比 1.18，p<0.001；最小值：1.33 比 0.95，p<0.001）的 ADC 平均值和最小值均显著升高。HgbA1c 与 AH 和 PTN ADC 平均值呈正相关（AH：p=0.036；PTN：p=0.004）。
我们的数据表明，水的扩散率随着 ADC 的增加是疾病病理生理学的结果。因此，踝关节 MRI-DWI 研究可用于识别糖尿病患者的神经病变，并无创性量化其严重程度。
与非糖尿病患者相比，糖尿病患者的拇展肌和胫后神经的 ADC 平均值和最小值显著升高。
HgbA1c 与 ADC 平均值呈正相关（AH：p=0.036；PTN：p=0.004），提示水在神经元和肌膜之间的扩散率增加是糖尿病神经病变病理生理学的结果。
踝关节 MRI-DWI 可用于临床无创识别糖尿病引起的神经病变改变。
