Proton magnetic resonance spectroscopy in the evaluation of patients with acute Charcot neuro-osteoarthropathy

Objective To evaluate whether bone marrow proton magnetic resonance spectroscopy (MRS) might provide a quantitative parameter able to assess disease activity in acute Charcot neuro-osteoarthropathy (CN). Methods Ten diabetic patients with stage 0 CN were prospectively evaluated at clinical onset and...

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Bibliographic Details
Published in:European radiology 2013-10, Vol.23 (10), p.2807-2813
Main Authors: Bolacchi, Francesca, Uccioli, Luigi, Masala, Salvatore, Giurato, Laura, Ruotolo, Valeria, Meloni, Marco, Baffari, Eleonora, Cinelli, Elenia, Cadioli, Marcello, Squillaci, Ettore, Simonetti, Giovanni, Bergamini, Alberto
Format: Article
Language:English
Subjects:
Arthropathy, Neurogenic - blood
Arthropathy, Neurogenic - diagnosis
Biomarkers - blood
Bone marrow
Diabetes
Diabetic Neuropathies - blood
Diabetic Neuropathies - diagnosis
Diabetic neuropathy
Diagnostic Radiology
Edema
Female
Humans
Imaging
Internal Medicine
Interventional Radiology
Lipids
Lipids - blood
Magnetic Resonance Spectroscopy - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Musculoskeletal
Neuroradiology
Peripheral neuropathy
Protons
Radiology
Reproducibility of Results
Sensitivity and Specificity
Spectrum analysis
Syndrome
Trauma
Tumor necrosis factor-TNF
Ultrasound
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Summary:Objective To evaluate whether bone marrow proton magnetic resonance spectroscopy (MRS) might provide a quantitative parameter able to assess disease activity in acute Charcot neuro-osteoarthropathy (CN). Methods Ten diabetic patients with stage 0 CN were prospectively evaluated at clinical onset and during treatment follow-up. The MRS lipid spectrum was analysed and a lipid polyunsaturation index (PUI) was calculated. Disease recovery was defined as the disappearance of bone marrow oedema as demonstrated on MRI short-tau-inversion-recovery (STIR) images. A 3-T MRI was used. Results Inter- and intra-individual PUI measurements generated reproducible results with approximately 7 % and 6 % variation respectively. Baseline PUI values were significantly higher in patients with acute CN compared with controls. Also, a significant positive correlation was observed between baseline PUI values and serum levels of IL-6 and TNF-α. During follow-up a gradual decrease in PUI was observed. The percentage reduction of PUI values at 3 months’ follow-up with respect to baseline values showed a negative correlation with recovery time. Conclusions Bone marrow MRS may provide a measurable index that allows progressive evaluation of disease activity in acute CN. MRS may be a complementary tool that can be used to guide clinicians in the management of acute CN patients. Key Points • Bone marrow MRS demonstrates lipid alterations in acute Charcot neuro-osteoarthropathy (CN). • Bone marrow MRS allows disease activity in acute CN to be evaluated. • MRS could become a new tool in the management of CN.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-013-2894-y