Structural Nerve Remodeling at 3-T MR Neurography Differs between Painful and Painless Diabetic Polyneuropathy in Type 1 or 2 Diabetes
Structural Nerve Remodeling at 3-T MR Neurography Differs between Painful and Painless Diabetic Polyneuropathy in Type 1 or 2 Diabetes
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DOI：
10.1148/radiol.2019191347
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发表时间：
2020-02-01
期刊：
影响因子：
19.7
通讯作者：
Kurz, Felix T.
中科院分区：
文献类型：
--
作者：
Jende, Johann M. E.;Groener, Jan B.;Kurz, Felix T.
背景资料：糖尿病性多发性神经病（DPN）疼痛症状的病理生理机制尚不清楚，可能与MRI特征有关，但尚未得到研究。目的：探讨DPN患者神经结构、负荷和神经病变的空间分布与疼痛的相关性。材料和方法：在这项前瞻性单中心横断面研究中，1型或2型糖尿病参与者在2015年6月至2018年3月期间自愿参加。参与者进行了3-T MR神经造影的坐骨神经与T2加权脂肪抑制序列，这是之前的临床和电生理测试。对于组比较，根据数据的高斯或非高斯分布进行方差分析或Kruskal-Wall检验。斯皮尔曼相关系数进行相关性分析。结果：共有131名参与者（平均年龄62岁+/- 11 [标准差]; 82名男性）患有1型糖尿病（n = 45）或2型糖尿病（n = 86），评估疼痛（n = 64），无痛（n = 37）或无（n = 30）DPN。有疼痛性糖尿病神经病变的参与者在整个神经体积中神经病变的百分比（15.2% +/- 1.6）高于无疼痛性DPN（10.4% +/- 1.7，P = 0.03）或无DPN（8.3% +/- 1.7; P
Background: The pathophysiologic mechanisms underlying painful symptoms in diabetic polyneuropathy (DPN) are poorly understood.They may be associated with MRI characteristics, which have not yet been investigated.Purpose: To investigate correlations between nerve structure, load and spatial distribution of nerve lesions, and pain in patients with DPN.Materials and Methods: In this prospective single-center cross-sectional study, participants with type 1 or 2 diabetes volunteered between June 2015 and March 2018. Participants underwent 3-T MR neurography of the sciatic nerve with a T2-weighed fat-suppressed sequence, which was preceded by clinical and electrophysiologic tests. For group comparisons, analysis of variance or the Kruskal-Wall is test was performed depending on Gaussian or non-Gaussian distribution of data. Spearman correlation coefficients were calculated for correlation analysis.Results: A total of 131 participants (mean age, 62 years +/- 11 [standard deviation]; 82 men) with either type 1 (n = 45) or type 2 (n = 86) diabetes were evaluated with painful (n = 64), painless (n = 37), or no (n = 30) DPN. Participants who had painful diabetic neuropathy had a higher percentage of nerve lesions in the full nerve volume (15.2% +/- 1.6) than did participants with nonpainful DPN (10.4% +/- 1.7, P = .03) or no DPN (8.3% +/- 1.7; P