caa a22 4500 475773020 CHVBK 20180406123623.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1007/s001250050025 doi (NATIONALLICENCE)springer-10.1007/s001250050025 1H- and 31P-magnetic resonance spectroscopy and imaging as a new diagnostic tool to evaluate neuropathic foot ulcers in Type II diabetic patients [Elektronische Daten] [E. Suzuki, A. Kashiwagi, H. Hidaka, H. Maegawa, Y. Nishio, H. Kojima, M. Haneda, H. Yasuda, S. Morikawa, T. Inubushi, R. Kikkawa] Aims/hypothesis. We studied 36 Type II (non-insulin-dependent) diabetic patients without occlusive arterial diseases in the lower extremities and 12 age-matched and sex-matched non-diabetic subjects to clarify the association between diabetic polyneuropathy and foot ulcers using 1H- and 31P-magnetic resonance spectroscopy and imaging.¶Methods. The 36 diabetic patients consisted of 12 patients with superficial foot ulcers and 24 patients free from this disease. We measured fat to water and phosphocreatine to inorganic phosphate (PCr:Pi) ratios and calculated the intracellular pH of resting plantar muscles by depth-resolved surface-coil spectroscopy using an 1H-31P double tuned coil. Furthermore, foot vasculature, fat and PCr contents of plantar muscles were visualised by phase-contrast angiography, T1-weighted spin-echo imaging and 31P-chemical shift imaging.¶Results. The 12 foot ulcer patients showed a reduced PCr to Pi ratio (p < 0.001) and peripheral nerve functions (p < 0.01-0.001) but an increased fat to water ratio (p < 0.001) and intracellular pH (p < 0.001) compared with the 24 patients without ulcers. From stepwise multiple regression analyses, motor nerve function as well as severity of nephropathy was associated with both fat to water and PCr to Pi ratios. When these patients were categorised into three groups based on their level of motor nerve function, the frequency of foot ulcers of the lowest group was higher than that of the highest group.¶Conclusion/interpretation. Our findings indicated that motor nerve dysfunction in diabetic patients was closely associated with impaired energy metabolism, fatty infiltration and increased intracellular pH of plantar muscles and high frequency of foot ulcers. These new techniques could contribute to help clarify the predisposing factors for foot ulcers. [Diabetologia (2000) 43: 165-172] Springer-Verlag Berlin Heidelberg, 2000 Keywords Magnetic resonance, spectroscopy, imaging, neuropathic foot ulcers, fat, phosphocreatine, intracellular pH nationallicence Suzuki E. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Kashiwagi A. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Hidaka H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Maegawa H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Nishio Y. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Kojima H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Haneda M. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Yasuda H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Morikawa S. Molecular Neurobiology Research Center, Shiga University of Medical Science, Shiga, Japan, JP aut Inubushi T. Molecular Neurobiology Research Center, Shiga University of Medical Science, Shiga, Japan, JP aut Kikkawa R. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut https://doi.org/10.1007/s001250050025 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s001250050025 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Suzuki E. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Kashiwagi A. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Hidaka H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Maegawa H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Nishio Y. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Kojima H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Haneda M. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Yasuda H. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Morikawa S. Molecular Neurobiology Research Center, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Inubushi T. Molecular Neurobiology Research Center, Shiga University of Medical Science, Shiga, Japan, JP aut NATIONALLICENCE 700 1- Kikkawa R. Third Department of Medicine, Shiga University of Medical Science, Shiga, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer