Quantitative assessment of diabetic amyotrophy using magnetic resonance neurography—a case-control analysis

Rocco Hlis, Feng Poh, Meredith Bryarly, Yin Xi, Avneesh Chhabra

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Abstract

Objectives: To quantitatively characterize diabetic amyotrophy (DA), or diabetic lumbosacral radiculoplexopathy, and compare with controls using magnetic resonance neurography (MRN). Methods: Forty controls and 23 DA cases were analyzed qualitatively and quantitatively. Cross-sectional areas (CSAs) of bilateral L3 through S2 lumbosacral nerve roots, femoral nerves, and sciatic nerves (proximal and distal measurements) were measured. A linear model was used to assess the nerve location and case/control effect on angle-corrected CSAs. Intra- and inter-reader analysis was performed using intraclass correlation (ICC). Results: In DA cases, abnormalities of the lumbosacral nerve roots, sciatic, femoral, and obturator nerves were seen in 21/23, 16/23, 21/23, and 9/23, respectively. Denervation abnormalities of multiple abdominopelvic muscles were seen. Quantitatively, the CSA of all measured LS plexus nerve roots and bilateral femoral nerves were significantly larger in DA cases vs. controls by 45% (95% CI, (30%, 49%); p < 0.001). The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92). Conclusions: Multifocal neuromuscular lesions related to diabetic amyotrophy were qualitatively and quantitatively detected on MRN. Qualitative abnormalities distinguished cases from controls, and nerve CSAs of cases were significantly larger than those of controls. Therefore, MRN may be employed as a non-invasive diagnostic tool for the evaluation of diabetic amyotrophy. Key Points: • Qualitative abnormalities of lumbosacral nerve roots, their peripheral branches, and muscles are seen in DA. • The lumbosacral nerve roots and their peripheral branches in diabetic amyotrophy cases are significantly larger in cross-sectional area than non-diabetic subjects by 45% (95 CI, 30%, 49%; p < 0.001). • The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92).

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StatePublished - Jan 1 2019

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Diabetic Neuropathies
Magnetic Resonance Spectroscopy
Femoral Nerve
Sciatic Nerve
Obturator Nerve
Multiple Abnormalities
Muscles
Denervation
Linear Models

Keywords

  • Diabetic amyotrophy
  • Diabetic neuropathies
  • Lumbosacral plexus
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{b0587047ffbe4e35bdb6556a7495cb45,
title = "Quantitative assessment of diabetic amyotrophy using magnetic resonance neurography—a case-control analysis",
abstract = "Objectives: To quantitatively characterize diabetic amyotrophy (DA), or diabetic lumbosacral radiculoplexopathy, and compare with controls using magnetic resonance neurography (MRN). Methods: Forty controls and 23 DA cases were analyzed qualitatively and quantitatively. Cross-sectional areas (CSAs) of bilateral L3 through S2 lumbosacral nerve roots, femoral nerves, and sciatic nerves (proximal and distal measurements) were measured. A linear model was used to assess the nerve location and case/control effect on angle-corrected CSAs. Intra- and inter-reader analysis was performed using intraclass correlation (ICC). Results: In DA cases, abnormalities of the lumbosacral nerve roots, sciatic, femoral, and obturator nerves were seen in 21/23, 16/23, 21/23, and 9/23, respectively. Denervation abnormalities of multiple abdominopelvic muscles were seen. Quantitatively, the CSA of all measured LS plexus nerve roots and bilateral femoral nerves were significantly larger in DA cases vs. controls by 45{\%} (95{\%} CI, (30{\%}, 49{\%}); p < 0.001). The ICC was moderate for inter-rater analysis = 0.547 (95{\%} CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95{\%} CI, 0.89–92). Conclusions: Multifocal neuromuscular lesions related to diabetic amyotrophy were qualitatively and quantitatively detected on MRN. Qualitative abnormalities distinguished cases from controls, and nerve CSAs of cases were significantly larger than those of controls. Therefore, MRN may be employed as a non-invasive diagnostic tool for the evaluation of diabetic amyotrophy. Key Points: • Qualitative abnormalities of lumbosacral nerve roots, their peripheral branches, and muscles are seen in DA. • The lumbosacral nerve roots and their peripheral branches in diabetic amyotrophy cases are significantly larger in cross-sectional area than non-diabetic subjects by 45{\%} (95 CI, 30{\%}, 49{\%}; p < 0.001). • The ICC was moderate for inter-rater analysis = 0.547 (95{\%} CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95{\%} CI, 0.89–92).",
keywords = "Diabetic amyotrophy, Diabetic neuropathies, Lumbosacral plexus, Magnetic resonance imaging",
author = "Rocco Hlis and Feng Poh and Meredith Bryarly and Yin Xi and Avneesh Chhabra",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00330-019-06162-3",
language = "English (US)",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Quantitative assessment of diabetic amyotrophy using magnetic resonance neurography—a case-control analysis

AU - Hlis, Rocco

AU - Poh, Feng

AU - Bryarly, Meredith

AU - Xi, Yin

AU - Chhabra, Avneesh

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: To quantitatively characterize diabetic amyotrophy (DA), or diabetic lumbosacral radiculoplexopathy, and compare with controls using magnetic resonance neurography (MRN). Methods: Forty controls and 23 DA cases were analyzed qualitatively and quantitatively. Cross-sectional areas (CSAs) of bilateral L3 through S2 lumbosacral nerve roots, femoral nerves, and sciatic nerves (proximal and distal measurements) were measured. A linear model was used to assess the nerve location and case/control effect on angle-corrected CSAs. Intra- and inter-reader analysis was performed using intraclass correlation (ICC). Results: In DA cases, abnormalities of the lumbosacral nerve roots, sciatic, femoral, and obturator nerves were seen in 21/23, 16/23, 21/23, and 9/23, respectively. Denervation abnormalities of multiple abdominopelvic muscles were seen. Quantitatively, the CSA of all measured LS plexus nerve roots and bilateral femoral nerves were significantly larger in DA cases vs. controls by 45% (95% CI, (30%, 49%); p < 0.001). The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92). Conclusions: Multifocal neuromuscular lesions related to diabetic amyotrophy were qualitatively and quantitatively detected on MRN. Qualitative abnormalities distinguished cases from controls, and nerve CSAs of cases were significantly larger than those of controls. Therefore, MRN may be employed as a non-invasive diagnostic tool for the evaluation of diabetic amyotrophy. Key Points: • Qualitative abnormalities of lumbosacral nerve roots, their peripheral branches, and muscles are seen in DA. • The lumbosacral nerve roots and their peripheral branches in diabetic amyotrophy cases are significantly larger in cross-sectional area than non-diabetic subjects by 45% (95 CI, 30%, 49%; p < 0.001). • The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92).

AB - Objectives: To quantitatively characterize diabetic amyotrophy (DA), or diabetic lumbosacral radiculoplexopathy, and compare with controls using magnetic resonance neurography (MRN). Methods: Forty controls and 23 DA cases were analyzed qualitatively and quantitatively. Cross-sectional areas (CSAs) of bilateral L3 through S2 lumbosacral nerve roots, femoral nerves, and sciatic nerves (proximal and distal measurements) were measured. A linear model was used to assess the nerve location and case/control effect on angle-corrected CSAs. Intra- and inter-reader analysis was performed using intraclass correlation (ICC). Results: In DA cases, abnormalities of the lumbosacral nerve roots, sciatic, femoral, and obturator nerves were seen in 21/23, 16/23, 21/23, and 9/23, respectively. Denervation abnormalities of multiple abdominopelvic muscles were seen. Quantitatively, the CSA of all measured LS plexus nerve roots and bilateral femoral nerves were significantly larger in DA cases vs. controls by 45% (95% CI, (30%, 49%); p < 0.001). The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92). Conclusions: Multifocal neuromuscular lesions related to diabetic amyotrophy were qualitatively and quantitatively detected on MRN. Qualitative abnormalities distinguished cases from controls, and nerve CSAs of cases were significantly larger than those of controls. Therefore, MRN may be employed as a non-invasive diagnostic tool for the evaluation of diabetic amyotrophy. Key Points: • Qualitative abnormalities of lumbosacral nerve roots, their peripheral branches, and muscles are seen in DA. • The lumbosacral nerve roots and their peripheral branches in diabetic amyotrophy cases are significantly larger in cross-sectional area than non-diabetic subjects by 45% (95 CI, 30%, 49%; p < 0.001). • The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456–0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89–92).

KW - Diabetic amyotrophy

KW - Diabetic neuropathies

KW - Lumbosacral plexus

KW - Magnetic resonance imaging

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U2 - 10.1007/s00330-019-06162-3

DO - 10.1007/s00330-019-06162-3

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C2 - 30980123

AN - SCOPUS:85064277391

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -