Top

Published in:

01-08-2017 | Magnetic Resonance

Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study

Authors: Chao Wu, Guangbin Wang, Yunxia Zhao, Wen Hao, Lianxin Zhao, Xinjuan Zhang, Jinfeng Cao, Shanshan Wang, Weibo Chen, Queenie Chan, Bin Zhao, Avneesh Chhabra

Published in: European Radiology | Issue 8/2017

Abstract

Objectives

To determine the diagnostic accuracy and interobserver performance of diffusion tensor imaging (DTI) in diabetic peripheral neuropathy (DPN) and detect correlations with electrophysiology.

Methods

Twelve healthy volunteers (controls) and ten DPN patients were enrolled to undergo MR examinations. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of tibial nerve (TN) and common peroneal nerve (CPN) were measured. Unpaired t test and Levene tests were performed to assess differences between the two groups. Receiver operating characteristic (ROC) analysis was performed for FA and ADC values. Pearson correlation coefficient was used to assess the correlation between DTI and electrophysiology parameters in the patient group.

Results

The FA values of TN and CPN in the DPN group were significantly lower and ADC were higher than the control group (p < 0.05). Interobserver agreement was excellent. FA positively correlated and ADC negatively correlated with motor nerve conduction velocity (MCV) (p < 0.05). There were no significant differences between motor nerve conduction amplitude and DTI parameters (p > 0.05). Moderate diagnostic accuracy of DTI was seen in the diagnosis of DPN.

Conclusions

DTI demonstrates moderate diagnostic accuracy and excellent interobserver performance in the detection of DPN involving the TN and CPN. There is moderate correlation with MCV.

Key Points

• FA values of TN and CPN are significantly lower in DPN.

• ADC values of TN and CPN are significantly higher in DPN.

• DTI demonstrates moderate diagnostic accuracy in detection of DPN.

• There is excellent interobserver performance in DTI measurements.

• Moderate correlation is seen between DTI parameters and MCV.

Vinik AI, Nevoret ML, Casellini C, Parson H (2013) Diabetic neuropathy. Endocrinol Metab Clin N Am 42:747–787CrossRef

Tavakoli M, Mitu-Pretorian M, Petropoulos IN et al (2013) Corneal confocal microscopy detects early nerve regeneration in diabetic neuropathy after simultaneous pancreas and kidney transplantation. Diabetes 62:254–260CrossRefPubMed

Shy ME, Frohman EM, So YT et al (2003) Quantitative sensory testing: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology 60:898–904CrossRefPubMed

Sumner CJ, Sheth S, Griffin JW, Cornblath DR, Polydefkis M (2003) The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology 60:108–111CrossRefPubMed

Chhabra A, Faridian-Aragh N (2012) High-resolution 3-T MR neurography of femoral neuropathy. AJR Am J Roentgenol 198:3–10CrossRefPubMed

Thakkar RS, Del Grand F, Thawait GK, Andreisek G, Carrino JA, Chhabra A (2012) Spectrum of high-resolution MRI findings in diabetic neuropathy. AJR Am J Roentgenol 199:407–412CrossRefPubMed

Wang D, Zhang X, Lu L et al (2015) Assessment of diabetic peripheral neuropathy in streptozotocin-induced diabetic rats with magnetic resonance imaging. Eur Radiol 25:463–471CrossRefPubMed

Alexander AL, Hasan K, Kindlmann G, Parker DL, Tsuruda JS (2000) A geometric analysis of diffusion tensor measurements of the human brain. Magn Reson Med 44:283–291CrossRefPubMed

SKorpil M, Engstrom M, Nordell A (2007) Diffusion-direction-dependent imaging: a novel MRI approach for peripheral nerve imaging. Magn Reson Imaging 25:406–411CrossRefPubMed

10.

Takako K, Hiroshi F, Keizo T et al (2011) Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study. Neuroradiology 53:955–960CrossRef

11.

Simon NG, Lagopoulos J, Gallagher T, Kliot M, Kiernan MC (2016) Peripheral nerve diffusion tensor imaging is reliable and reproducible. J Magn Reson Imaging 43:962–969CrossRefPubMed

12.

Breckwoldt MO, Stock C, Xia A et al (2015) Diffusion tensor imaging adds diagnostic accuracy in magnetic resonance neurography. Invest Radiol 50:498–504CrossRefPubMed

13.

Preston DC, Shapiro BE (2012) Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations, 3rd edn. Elsevier, Amsterdam

14.

Das HK, Das D, Doley R, Sahu PP (2016) Quantifying demyelination in NK venom treated nerve using its electric circuit model. Sci Rep. doi:10.1038/srep22385

15.

Haakma W, Jongbloed BA, Froeling M et al (2016) MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy. Eur Radiol. doi:10.1007/s00330-016-4575-0 PubMedPubMedCentral

16.

Landis JF, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed

17.

Tesfaye S, Selvarajah D (2012) Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes Metab Res Rev 28:8–14CrossRefPubMed

18.

Pham M, Oikonomou D, Hornung B et al (2015) Magnetic resonance neurography detects diabetic neuropathy early and with proximal predominance. Ann Neurol 78:939–948CrossRefPubMedPubMedCentral

19.

Westerhausen R, Kreuder F, Sequeira SDS et al (2004) Effects of handedness and gender on macro- and microstructure of the corpus callosum and its subregions: a combined high-resolution and diffusion-tensor MRI study. Cognit Brain Res 21:418–426CrossRef

20.

Tagliafico A, Calabrese M, Puntoni M et al (2001) Brachial plexus MR imaging: accuracy and reproducibility of DTI-derived measurements and fiber tractography at 3.0-T. Eur Radiol 21:1764–1771CrossRef

21.

Wan Q, Wang S, Zhou J et al (2016) Evaluation of radiation-induced peripheral nerve injury in rabbits with MR neurography using diffusion tensor imaging and T₂ measurements: correlation with histological and functional change. J Magn Reson Imaging 43:1492–1499CrossRefPubMed

22.

Chhabra A, Thakkar RS, Andreisek G et al (2013) Anatomic MR imaging and functional diffusion tensor imaging of peripheral nerve tumors and tumorlike conditions. Am J Neuroradiol 34:802–807CrossRefPubMed

23.

Zhou Y, Kumaravel M, Patel VS, Sheikh KA, Narayana PA (2012) Diffusion tensor imaging of forearm nerves in humans. J Magn Reson Imaging 36:920–927CrossRefPubMedPubMedCentral

24.

Kabakci N, Gurses B, Firat Z et al (2007) Diffusion tensor imaging and tractography of median nerve: normative diffusion values. Am J Roentgenol 189:923–927CrossRef

25.

Stein D, Neufeld A, Pasternak O et al (2009) Diffusion tensor imaging of the median nerve in healthy and carpal tunnel syndrome subjects. J Magn Reson Imaging 29:657–662CrossRefPubMed

26.

Wang CK, Jou IM, Huang HW et al (2012) Carpal tunnel syndrome assessed with diffusion tensor imaging: comparison with electrophysiological studies of patents and healthy volunteers. Eur J Radiol 81:3378–3383CrossRefPubMed

27.

Breitenseher JB, Kranz G, Hold A et al (2015) MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study. Eur Radiol 25:1911–1918CrossRefPubMed

28.

Jengojan S, Kovar F, Breitenseher J, Weber M, Prayer D, Kasprian G (2015) Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography. Eur Radiol 25:1678–1683CrossRefPubMed

29.

Behse F (1997) Nerve biopsy and conduction studies in diabetic neuropathy. J Neurol 40:1072–1082

30.

Jeantroux J, Kremer S, Lin XZ et al (2012) Diffusion tensor imaging of normal appearing white matter in neuromyelitis optica. J Neuroradiol 39:295–300CrossRefPubMed

Title: Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study
Authors: Chao Wu
Guangbin Wang
Yunxia Zhao
Wen Hao
Lianxin Zhao
Xinjuan Zhang
Jinfeng Cao
Shanshan Wang
Weibo Chen
Queenie Chan
Bin Zhao
Avneesh Chhabra
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4698-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 8/2017

Contrast-enhanced CT in determining resectability in patients with pancreatic carcinoma: a meta-analysis of the positive predictive values of CT

Emergency assessment of patients with acute abdominal pain using low-dose CT with iterative reconstruction: a comparative study

MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer

Effect of inversion time on the precision of myocardial late gadolinium enhancement quantification evaluated with synthetic inversion recovery MR imaging

Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer

Development and validation of a prediction model for measurement variability of lung nodule volumetry in patients with pulmonary metastases