Advertisement
-
1
Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, et al: The global burden of diabetic foot disease. Lancet 366: 1719, 2005.
-
2
Wild S, Roglic G, Green A, et al: Global prevalence of diabetes: estimates for the year 2000 projections for 2030. Diabetes Care 27: 1047, 2004.
-
3
Lipsky BA, Itani K, Norden C; Linezolid Diabetic Foot Infections Study Group: Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect Dis 38: 17, 2004.
-
4
Lipsky BA, Berendt AR, Deery HG, et al: Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 39: 885, 2004.
-
5
Tomar V, Yadav A, Rathore RK, et al: Apparent diffusion coefficient with higher b-value correlates better with viable cell count quantified from the cavity of brain abscess. Am J Neuroradiol 32: 2120, 2011.
-
6
Aube C, Racineux PX, Lebigot J, et al: Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results. J Radiol 85: 301, 2004.
-
7
Kapoor A, Page S, Lavalley M, et al: Magnetic resonance imaging for diagnosing foot osteomyelitis: a meta-analysis. Arch Intern Med 167: 125, 2007.
-
8
Bley TA, Wieben O, Uhl M: Diffusion-weighted MR imaging in musculoskeletal radiology: applications in trauma, tumors, and inflammation. Magn Reson Imaging Clin N Am 17: 263, 2009.
-
9
Takebe N, Iwasaki K, Hashikata H, et al: Intramedullary spinal cord abscess and subsequent granuloma formation: a rare complication of vertebral osteomyelitis detected by diffusion-weighted magnetic resonance imaging. Neurosurg Focus 37: 12, 2014.
-
10
Ozgen B, Oguz KK, Cila A: Diffusion MR imaging features of skull base osteomyelitis compared with skull base malignancy. Am J Neuroradiol 32: 179, 2011.
-
11
Parmar HA, Sitoh YY: Diffusion-weighted imaging findings in central skull base osteomyelitis with pharyngeal abscess formation. Am J Roentgenol 184: 1363, 2005.
-
12
Moritani T, Kim J, Capizzano AA, et al: Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections. Br J Radiol 87: 20140011, 2014.
-
13
Aube C, Racineux PX, Lebigot J, et al: Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results [in French]. J Radiol 85: 301, 2004.
-
14
Colagrande S, Carbone SF, Carusi LM, et al: Magnetic resonance diffusion-weighted imaging: extraneurological applications. Radiol Med 111: 392, 2006.
-
15
Khoo MM, Tyler PA, Saifuddin A, et al: Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review. Skeletal Radiol 40: 665, 2011.
-
16
Abdel Razek AA, Samir S: Diagnostic performance of diffusion-weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot. Eur J Radiol 89: 221, 2017.
-
17
Ebisu T, Tanaka C, Umeda M, et al: Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging. Magn Reson Imaging 14: 1113, 1996.
-
18
Xu XX, Li B, Yang HF, et al: Can diffusion-weighted imaging be used to differentiate brain abscess from other ring-enhancing brain lesions? a meta-analysis. Clin Radiol 69: 909, 2014.
-
19
Schmid-Tannwald C, Schmid-Tannwald CM, Morelli JN, et al: Role of diffusion-weighted MRI in differentiation of hepatic abscesses from non-infected fluid collections. Clin Radiol 69: 687, 2014.
-
20
Nguyen TL, Soyer P, Barbe C, et al: Diagnostic value of diffusion-weighted magnetic resonance imaging in pelvic abscesses. J Comput Assist Tomogr 37: 971, 2013.
-
21
Parmar HA, Sitoh YY: Diffusion-weighted imaging findings in central skull base osteomyelitis with pharyngeal abscess formation. AJR Am J Roentgenol 184: 1363, 2005.
-
22
Ozgen B, Oguz KK, Cila A: Diffusion MR imaging features of skull base osteomyelitis compared with skull base malignancy. AJNR Am J Neuroradiol 32: 179, 2011.
-
23
Patel KB, Poplawski MM, Pawha PS, et al: Diffusion-weighted MRI “claw sign” improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. Am J Neuroradiol 35: 1647, 2014.
-
24
Luthra G, Parihar A, Nath K, et al: Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. Am J Neuroradiol 28: 1332, 2007.
The Clinical Value of Diffusion-Weighted Magnetic Resonance Imaging in Diabetic Foot Infection
Background:
Osteomyelitis is a common complication in the diabetic foot that can conclude with amputation. The purpose of this study was to evaluate the role of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis of osteomyelitis in diabetic foot ulcer (DFU).
Methods:
Thirty patients with type 2 diabetes mellitus and a DFU were enrolled. Both DWIs and conventional MRIs were obtained. Apparent diffusion coefficient (ADC) measurements were made by transferring the images to a workstation. The measurements were made both from bone with osteomyelitis, or nearest to the injured area if osteomyelitis is not available, and from the adjacent soft tissue.
Results:
The patients comprised nine women (30%) and 21 men (70%) with a mean age of 58.7 years (range, 41–78 years). The levels of ADC were significantly low (P = .022) and the erythrocyte sedimentation rates were significantly high (P = .014) in patients with osteomyelitis (n = 9) compared with patients without osteomyelitis (n = 21). The mean ± SD bone ADC value (0.75 ± 0.16 × 10–3 mm2/sec) was significantly lower than the adjacent soft-tissue ADC value (0.90 ± 0.15 × 10–3 mm2/sec) in patients with osteomyelitis (P = .04).
Conclusions:
It is suggested that DWI contributes to conventional MRI with short imaging time and no requirement for contrast agent. Therefore, DWI may be an alternative diagnostic method for the evaluation of DFU and the detection of osteomyelitis.
