Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study
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 cou...
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| Veröffentlicht in: | European radiology 2023-07, Vol.33 (7), p.4855-4863 |
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| creator | Amaya, Joshua Lue, Brian Silva, Flavio Duarte Raspovic, Katherine Xi, Yin Chhabra, Avneesh |
| description | 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
mm
2
/s) of the AH muscle (mean: 1.77 vs 1.39,
p
|
| doi_str_mv | 10.1007/s00330-023-09466-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2778979748</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2778979748</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ef093ebf9b08785fc522611f6dbd74f258fed4abbbecd5635a7c1e9d40a08d7e3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhSMEog_4AyyQJTbdBPxK7LCrZlqoVISEQCwtx76euiTOYDug6V_iT-LJlIdYsLKl853j63uq6hnBLwnG4lXCmDFcY8pq3PG2rcWD6phwRmuCJX_41_2oOknpFmPcES4eV0eslbhtWnFc_Vh75-bkp1B_B7-5yWDRuw_Ij3rjwwbpYNGc_eDzDk0Ona9XaASd5ggjhJyQD8jc6KhNhujv9o4A8RssvnFOZoC9HjawoNbrHrI3aKuzX_xTKOiXQq0_X6GUZ-shvUYamTilVCcwuUymh0XaPakeOT0keHp_nlafLi8-rt7W1-_fXK3Or2vDRJNrcLhj0Luux1LIxpmG0pYQ19reCu5oIx1Yrvu-B2ObljVaGAKd5VhjaQWw0-rskLuN09cZUlajTwaGQQeY5qSoELITneCyoC_-QW-nOZaJCyVpoTilpFD0QC3fiuDUNpYNx50iWO2rVIcqValSLVUqUUzP76PnfgT72_KruwKwA5CKVFYc_7z9n9ifJEOs0g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2828974221</pqid></control><display><type>article</type><title>Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study</title><source>Springer Nature - Complete Springer Journals</source><creator>Amaya, Joshua ; Lue, Brian ; Silva, Flavio Duarte ; Raspovic, Katherine ; Xi, Yin ; Chhabra, Avneesh</creator><creatorcontrib>Amaya, Joshua ; Lue, Brian ; Silva, Flavio Duarte ; Raspovic, Katherine ; Xi, Yin ; Chhabra, Avneesh</creatorcontrib><description>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
mm
2
/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.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-09466-7</identifier><identifier>PMID: 36806567</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Ankle ; Correlation coefficient ; Correlation coefficients ; Cross-sectional studies ; Diabetes ; Diabetes mellitus ; Diabetic neuropathy ; Diagnostic Radiology ; Diffusion coefficient ; Diffusivity ; Image quality ; Imaging ; Internal Medicine ; Interventional Radiology ; Magnetic resonance imaging ; Medical imaging ; Medicine ; Medicine & Public Health ; Membranes ; Muscles ; Musculoskeletal ; Nerves ; Neuroradiology ; Pathophysiology ; Radiology ; Tibial nerve ; Ultrasound</subject><ispartof>European radiology, 2023-07, Vol.33 (7), p.4855-4863</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ef093ebf9b08785fc522611f6dbd74f258fed4abbbecd5635a7c1e9d40a08d7e3</citedby><cites>FETCH-LOGICAL-c375t-ef093ebf9b08785fc522611f6dbd74f258fed4abbbecd5635a7c1e9d40a08d7e3</cites><orcidid>0000-0002-0718-3802</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-023-09466-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-023-09466-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36806567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amaya, Joshua</creatorcontrib><creatorcontrib>Lue, Brian</creatorcontrib><creatorcontrib>Silva, Flavio Duarte</creatorcontrib><creatorcontrib>Raspovic, Katherine</creatorcontrib><creatorcontrib>Xi, Yin</creatorcontrib><creatorcontrib>Chhabra, Avneesh</creatorcontrib><title>Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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
mm
2
/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.</description><subject>Ankle</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Cross-sectional studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic neuropathy</subject><subject>Diagnostic Radiology</subject><subject>Diffusion coefficient</subject><subject>Diffusivity</subject><subject>Image quality</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Magnetic resonance imaging</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Membranes</subject><subject>Muscles</subject><subject>Musculoskeletal</subject><subject>Nerves</subject><subject>Neuroradiology</subject><subject>Pathophysiology</subject><subject>Radiology</subject><subject>Tibial nerve</subject><subject>Ultrasound</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtv1DAUhSMEog_4AyyQJTbdBPxK7LCrZlqoVISEQCwtx76euiTOYDug6V_iT-LJlIdYsLKl853j63uq6hnBLwnG4lXCmDFcY8pq3PG2rcWD6phwRmuCJX_41_2oOknpFmPcES4eV0eslbhtWnFc_Vh75-bkp1B_B7-5yWDRuw_Ij3rjwwbpYNGc_eDzDk0Ona9XaASd5ggjhJyQD8jc6KhNhujv9o4A8RssvnFOZoC9HjawoNbrHrI3aKuzX_xTKOiXQq0_X6GUZ-shvUYamTilVCcwuUymh0XaPakeOT0keHp_nlafLi8-rt7W1-_fXK3Or2vDRJNrcLhj0Luux1LIxpmG0pYQ19reCu5oIx1Yrvu-B2ObljVaGAKd5VhjaQWw0-rskLuN09cZUlajTwaGQQeY5qSoELITneCyoC_-QW-nOZaJCyVpoTilpFD0QC3fiuDUNpYNx50iWO2rVIcqValSLVUqUUzP76PnfgT72_KruwKwA5CKVFYc_7z9n9ifJEOs0g</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Amaya, Joshua</creator><creator>Lue, Brian</creator><creator>Silva, Flavio Duarte</creator><creator>Raspovic, Katherine</creator><creator>Xi, Yin</creator><creator>Chhabra, Avneesh</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0718-3802</orcidid></search><sort><creationdate>20230701</creationdate><title>Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study</title><author>Amaya, Joshua ; Lue, Brian ; Silva, Flavio Duarte ; Raspovic, Katherine ; Xi, Yin ; Chhabra, Avneesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ef093ebf9b08785fc522611f6dbd74f258fed4abbbecd5635a7c1e9d40a08d7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ankle</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Cross-sectional studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetic neuropathy</topic><topic>Diagnostic Radiology</topic><topic>Diffusion coefficient</topic><topic>Diffusivity</topic><topic>Image quality</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Magnetic resonance imaging</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Membranes</topic><topic>Muscles</topic><topic>Musculoskeletal</topic><topic>Nerves</topic><topic>Neuroradiology</topic><topic>Pathophysiology</topic><topic>Radiology</topic><topic>Tibial nerve</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amaya, Joshua</creatorcontrib><creatorcontrib>Lue, Brian</creatorcontrib><creatorcontrib>Silva, Flavio Duarte</creatorcontrib><creatorcontrib>Raspovic, Katherine</creatorcontrib><creatorcontrib>Xi, Yin</creatorcontrib><creatorcontrib>Chhabra, Avneesh</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amaya, Joshua</au><au>Lue, Brian</au><au>Silva, Flavio Duarte</au><au>Raspovic, Katherine</au><au>Xi, Yin</au><au>Chhabra, Avneesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>33</volume><issue>7</issue><spage>4855</spage><epage>4863</epage><pages>4855-4863</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>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
mm
2
/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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36806567</pmid><doi>10.1007/s00330-023-09466-7</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0718-3802</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2023-07, Vol.33 (7), p.4855-4863 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2778979748 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Ankle Correlation coefficient Correlation coefficients Cross-sectional studies Diabetes Diabetes mellitus Diabetic neuropathy Diagnostic Radiology Diffusion coefficient Diffusivity Image quality Imaging Internal Medicine Interventional Radiology Magnetic resonance imaging Medical imaging Medicine Medicine & Public Health Membranes Muscles Musculoskeletal Nerves Neuroradiology Pathophysiology Radiology Tibial nerve Ultrasound |
| title | Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study |
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