| Objective: Using DW-MRN and DTI to explore the changes of tibial nerve and common peroneal nerve in type 2 diabetes mellitus with peripheral neuropathy,to investigate the application of diffusion imaging in diabetic peripheral neuropathy.Materials and Methods: Sixty subjects were enrolled in this perspective study,including 20 case of diabetes mellitus with peripheral neuropathy?DPN?,20 case of type 2 diabetes mellitus without peripheral neuropathy?T2DM?and 20 case of healthy controls?HC?.The general conditions of the subjects were collected,including sex,age,height,weight,diabetes related laboratory indicators,motor nerve conduction velocity?MCV?from electromyogram?EMG?and michigan neuropathy screening instrument?MNSI?score.All subjects underwent magnetic resonance imaging,including T1 WI,T2WI/FS,MEDIC,DWI-MRN,DTI sequences.Region of interest?ROI?of DTI image was selected through the magnetic resonance post-processing technique,and FA value and ADC value of tibial nerve and common peroneal nerve were obtained automatically,then repeat these actions three times and take the mean value.As the same time observing the changes of signal and morphology of tibial nerve and common peroneal nerve.We use SPSS 22 to process data.Two independent sample t test was used to compare the difference of DPN group and T2DM group.Single factor analysis of variance was used to measure the data among the three groups.The correlation among FA/ADC value and nerve conduction velocity,clinical indexes were analyzed.Results:?1?There was difference between DPN group and T2DM group in laboratory related biochemical parameters and MNSI score,the difference of HbA1c,LDL-C,C peptide and MNSI score between DPN group and T2DM group was statistically significant?P<0.05?.?2?The MCV of tibial nerve and common peroneal nerve in group DPN?43.42±3.59m/s,44.05±3.01m/s?were slower than those in group T2DM?46.43±2.86m/s,46.83±2.86m/s?and group HC?46.89±2.75m/s,47.03±2.37m/s?,and there were significant difference among the three groups?P<0.05?.?3?The FA value of tibial nerve and common peroneal nerve in group DPN?0.528±0.073,0.489±0.052?was lower than that in group T2DM?0.582±0.048,0.537±0.049?and group HC?0.593±0.069,0.547±0.050?,and there were significant difference among the three groups?P<0.05?.The ADC value of tibial nerve and common peroneal nerve in group DPN(1.173±0.103×10-3mm2/s,1.107±0.085×10-3mm2/s)was higher than that in group T2DM(1.077±0.083×10-3mm2/s,1.027±0.075×10-3mm2/s)and group HC(1.070±0.077×10-3mm2/s,1.020±0.065×10-3mm2/s),and there were significant difference among the three groups?P<0.05?.?4?There was a significant positive correlation between the FA value of tibial nerve and MCV?r=0.696,P<0.001;r=0.728,P<0.001?,and negative correlation between the ADC value of tibial nerve and MCV?r=-0.672,P < 0.001;r=-0.636,P < 0.001?.?5?There were negative correlation among the FA value and HbA1c,LDL-C,course of disease?r were-0.397,-0.415,-0.341,respectively;P<0.05?,and positive correlation between the FA value and C peptide?r=0.355,P<0.05?.There were positive correlation among the ADC value and HbA1c,LDL-C,course of disease?r were 0.598,0.552,0.361,respectively;P<0.05?,and negative correlation between the ADC value and C peptide?r=-0.512,P<0.05?.Conclusion: DW-MRN and DTI can monitor orientation of tibial nerve and common peroneal nerve and analysis the injury of nerve quantitatively,thus they can be used to estimate the injury of tibial nerve and common peroneal nerve of T2DM. |
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