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

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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Abbreviations

ADC:

apparent diffusion coefficient

AUC:

area under the ROC curve

CI:

confidence interval

CPN:

common peroneal nerve

DM:

diabetes mellitus

DPN:

diabetic peripheral neuropathy

DTI:

diffusion tensor imaging

FA:

fractional anisotropy

FOV:

field of view

ICC:

intraclass correlation coefficient

MCV:

motor nerve conduction velocity

MRI:

magnetic resonance imaging

QST:

quantitative neurosensory testing

ROI:

region of interest

ROC:

receiver operating characteristic

SPAIR:

spectral adiabatic inversion recovery

TE:

echo time

TN:

tibial nerve

TR:

repetition time

2D:

two-dimensional

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Acknowledgements

The scientific guarantor of this publication is Bin Zhao. The authors declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work was supported by the National Natural Science Foundation of China under Grant Nos. 81371534 and 81671668. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subject or cohort was previously reported.

Methodology: prospective, case–control study, performed at one institution

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Authors and Affiliations

  1. Department of MR, Shandong Medical Imaging Research Institute, Shandong University, 324, Jingwu Road, Jinan, Shandong, 250021, People’s Republic of China

    Chao Wu, Guangbin Wang, Wen Hao, Xinjuan Zhang, Jinfeng Cao, Shanshan Wang & Bin Zhao

  2. Department of Electromyogram, Shandong provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 250021, People’s Republic of China

    Yunxia Zhao

  3. Department of Radiology, Qilu Hospital Affiliated to Shandong University, Jinan, Shandong, 250012, People’s Republic of China

    Lianxin Zhao

  4. Philips Healthcare, Shanghai, China

    Weibo Chen & Queenie Chan

  5. UT southwestern Medical Center, Dallas, Tx, USA

    Avneesh Chhabra

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  1. Chao Wu
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  2. Guangbin Wang
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  3. Yunxia Zhao
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  11. Bin Zhao
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Correspondence to Bin Zhao.

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Wu, C., Wang, G., Zhao, Y. et al. Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study. Eur Radiol 27, 3523–3531 (2017). https://doi.org/10.1007/s00330-016-4698-3

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  • DOI: https://doi.org/10.1007/s00330-016-4698-3

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