-
[show abstract]
[hide abstract]
ABSTRACT: Although a variety of diagnostic imaging modalities are available for the evaluation of diabetes-related foot complications, the distinction between neuroarthropathy and osteomyelitis is still challenging. The early and accurate diagnosis of diabetic foot complications can help reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emission tomography are the main procedures currently in use for the evaluation of diabetes-related foot complications. However, each of these modalities does not provide enough information alone and a multimodal approach should be used for an accurate diagnosis. The present study is a review of the current concepts in imaging of diabetes-related foot complications and an analysis of the advantages and disadvantages of each method. D iabetes mellitus (DM) is a multi-systemic disease that is associated with significant complications affecting multiple organs. The worldwide pre-valence of DM is currently estimated at 5.1% and is predicted to reach 7.7% by 2030 (1). DM is mainly a neurovascular disease that particularly affects the mus-culoskeletal system, especially the foot (2). Vasculopathy, neuropathy, and infection are the three major pathologi-cal processes that lead to the development of diabetes-related foot complications (3). An altered immune response (i.e. defective phagocytosis and microbicidal activity of granulocytes) is an equally responsible factor in the development of infectious foot complications (4). The differentiation of soft tissue infection from an accompanying osteomyelitis and the early detection of abscess formation are the main goals of diagnostic imaging procedures (5). The prompt and efficient medical treatment of the diabetic foot is essential to avoid amputation (2). The most commonly used techniques for the multimodal imaging of the diabetic foot are plain radiography (PR), ultrasonography (US), magnetic reso-nance imaging (MRI), and nuclear medicine scintigraphy (NMS). Computed tomography (CT) is not sensitive enough but is widely used in combination with positron emission tomography (PET) (5Á7).
Diabetic Foot and Ankle. 10/2012; 3:18754.
-
[show abstract]
[hide abstract]
ABSTRACT: Although a variety of diagnostic imaging modalities are available for the evaluation of diabetes-related foot complications, the distinction between neuroarthropathy and osteomyelitis is still challenging. The early and accurate diagnosis of diabetic foot complications can help reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emission tomography are the main procedures currently in use for the evaluation of diabetes-related foot complications. However, each of these modalities does not provide enough information alone and a multimodal approach should be used for an accurate diagnosis. The present study is a review of the current concepts in imaging of diabetes-related foot complications and an analysis of the advantages and disadvantages of each method.
Diabetic foot & ankle. 01/2012; 3.
-
[show abstract]
[hide abstract]
ABSTRACT: Meningiomas are mostly benign, however atypical or malignant subtypes with more aggressive clinical course and higher recurrence rates can also be seen. The purpose of this study was to determine whether histopathological subtypes of meningiomas could be assessed preoperatively using apparent diffusion coefficient (ADC) values.
Conventional magnetic resonance (MR) and diffusion-weighted (DW) imaging of 177 adult patients with pathologically proven meningiomas were retrospectively evaluated. Tumor size and the degree of associated edema were noted. The signal intensity of the lesions on DW imaging was evaluated and graded. Mean ADC values were obtained as the mean of measurements from three regions of interests within the mass. ADC ratios of meningioma/contralateral normal appearing subcortical parietal white matter were also calculated.
The histopathological analysis revealed 135 benign, 37 atypical and 5 malignant lesions. With classification according to the subtype, the mean ADC values and ratios of benign meningiomas were as 0.99±0.12×10(-3) mm(2)/s and 1.22±0.07, respectively. ADC values for atypical and malignant groups were both 0.84±0.1×10(-3) mm(2)/s. The ADC ratios were 1.05±0.1 and 0.96±0.2 for atypical and malignant subtypes, respectively. There was no statistically significant difference between the mean ADC ratios of the three subtypes (ANOVA test; P≥0.05). Gender, age of the patients and tumor size showed no statistically significant difference between the different histological groups.
DW MR imaging was not found to have any additional value in determining histological behaviour nor in differentiating histopathological subtypes of meningiomas.
European journal of radiology 06/2011; 81(9):2389-95. · 2.65 Impact Factor
