Dynamic contrast-enhanced magnetic resonance imaging for differentiating osteomyelitis from acute neuropathic arthropathy in the complicated diabetic foot

作者：Liao, Dan; Xie, Liqiu; Han, Yongliang; Du, Silin; Wang, Hansheng; Zeng, Chun; Li, Yongmei^*

来源：Skeletal Radiology, 2018, 47(10): 1337-1347.

DOI：10.1007/s00256-018-2942-4

• Diabetic foot
• Osteomyelitis
• Neuropathic arthropathy
• Dynamic contrast-enhanced imaging
• C-reactive protein
• Erythrocyte sedimentation rate

ObjectiveThe main purpose of this study was to investigate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating osteomyelitis from acute neuropathic arthropathy in the diabetic foot. @@@ Materials and Methods This prospective study was carried out on 30 diabetic foot patients, with a mean age of 51 years. The patients all underwent clinical examinations, laboratory examinations and DCE-MRI. The DCE-MRI parameters (K-trans, K-ep and V-e) of the regions of acute neuropathic arthropathy and osteomyelitis were calculated. Receiver operating characteristic curves (ROCs) were used to identify the DCE-MRI parameters that showed the highest accuracy in differentiating the acute neuropathic arthropathy from the osteomyelitic regions. Pearson correlation coefficients were used to assess the correlations among the DCE-MRI parameters, the level of C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR). @@@ Results The K-trans, K-ep and V-e values of the osteomyelitic regions were higher than those of the acute neuropathic arthropathy regions, and significant differences were found between the two groups (P = 0.000, P = 0.000, P = 0.000). The ROC analysis showed that K-trans and V-e performed best in differentiating osteomyelitis from acute neuropathic arthropathy, both with an area under the cObjectiveurve of 0.938. The Pearson correlation coefficients showed that the DCE-MRI parameters correlated significantly with the level of CRP and ESR (P = 0.000, P = 0.014, P = 0.000; P = 0.000, P = 0.000, P = 0.013). @@@ Conclusions Our results showed that DCE-MRI may provide reproducible parameters that can reliably differentiate osteomyelitis from acute neuropathic arthropathy.

• 出版日期2018-10
• 单位重庆医科大学