Knowledge of the state of tissue hydration in patients suffering from peripheral vascular disease and neuropathy as a result of diabetes is important in their treatment. Further, because magnetic resonance imaging (MRI) is uniquely able to generate information about soft tissues and their water content, it is ideal for studying disorders of this kind. The feet and hands, often affected in diabetes, are ideal for studying fundamental aspects of the disease state and the response of patients to treatment. In this preliminary study, two related areas are reported: the measurement of diffusion coefficients in the finger and the visualization of the distribution of edema and muscle atrophy in the feet of people suffering from diabetes. Diffusion coefficients of water have been measured in the normal finger as a baseline study for a current patient study. It was found that the measured diffusion coefficient increased with subject age; this is not consistent with a direct-hydration model and it is conjectured that this could be linked to structural changes in proteins. Linked to this study, we have also imaged the feet of patients suffering from diabetes. Magnetization transfer has clearly demonstrated changes in muscle tissue with atrophy caused by motor neuropathy-in general, the amount of tissue water is increased as muscle volume decreases. Further, it is evident that these changes can be related to changes in cross-linking of protein and collagen molecules as muscle fibers become thinned, thus relating these studies to the diffusion coefficient measurements. The studies of the feet have also revealed artifacts in the images, consistent with the deposition of ferrous material in tissues. It is surmised that this is caused by hemosiderin deposits at ulcer sites associated with progress of the disease. MRI could be a useful tool for monitoring the distribution of ulcers below the skin surface and provide a means of determining the response of patients to treatment.
|Number of pages
|Magma: Magnetic Resonance Materials in Physics, Biology, and Medicine
|Published - Oct 1994
- muscle atrophy