Diffusion tensor imaging MR Neurography detects polyneuropathy in type 2 diabetes

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  • M Vaeggemose
  • W Haakma
  • M Pham, Department of Neuroradiology, Heidelberg University Hospital, Germany; Department of Neuroradiology, Würzburg University Hospital, Germany.
  • ,
  • S Ringgaard
  • ,
  • H Tankisi
  • N Ejskjaer, Department of Clinical Genetics, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University Hospital, Denmark.
  • ,
  • S Heiland, Department of Neuroradiology, Heidelberg University Hospital, Germany.
  • ,
  • P L Poulsen
  • H Andersen

AIM: To evaluate if diffusion-tensor-imaging MR-Neurography (DTI-MRN) can detect lesions of peripheral nerves due to polyneuropathy in patients with type 2 diabetes.

METHODS: Ten patients with type 2 diabetes with polyneuropathy (DPN), 10 patients with type 2 diabetes without polyneuropathy (nDPN) as well as 20 healthy controls (HC) were included. DTI-MRN covered proximal (sciatic nerve) and distal regions (tibial nerve) of the lower extremity. Fractional-anisotropy (FA) and diffusivity (mean (MD), axial (AD) and radial (RD)) were calculated and compared to neuropathy severity. Conventional T2-relaxation-time and proton-spin-density data were obtained from a multi-echo SE sequence. Furthermore, we evaluated sensitivity and specificity of DTI-MRN from receiver operating characteristics (ROC).

RESULTS: The proximal and distal FA was lowest in patients with DPN compared with nDPN and HC (p < 0.01). Likewise, proximal and distal RD was highest in patients with DPN (p < 0.01). MD and AD were also significantly different though less pronounced. ROC curve analyses of DTI separated nDPN and DPN with area-under-the-curve values ranging from 0.65 to 0.98. T2-relaxation-time and proton-spin-density could not differentiate between nDPN and DPN.

CONCLUSION: DTI-MRN accurately detects DPN by lower nerve FA and higher RD. These alterations are likely to reflect both proximal and distal nerve fiber pathology in patients with type 2 diabetes.

Original languageEnglish
Article number107439
JournalJournal of Diabetes and its Complications
Volume34
Issue2
ISSN1056-8727
DOIs
Publication statusPublished - Feb 2020

    Research areas

  • Diabetes, Diffusion tensor imaging, Magnetic resonance neurography, Neuropathy, Receiver operating characteristics, Type 2 diabetes

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