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Eur Radiol. 2013 Oct;23(10):2807-13. doi: 10.1007/s00330-013-2894-y. Epub 2013 Jun 11.

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

Author information

1
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiation Therapy, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy, f.bolacchi@tiscali.it.

Abstract

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.

PMID:
23754462
DOI:
10.1007/s00330-013-2894-y
[Indexed for MEDLINE]

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