Ahmed Abdel Razek MD, Presenter: Nothing to Disclose

Ehab Saad, Abstract Co-Author: Nothing to Disclose

To evaluate the role of diffusion weighted echoplanar MR imaging in differentiation of diabetic osteoarthopathy from osteomyelitis of diabetic foot.

Prospective study was conducted on 31 consecutive patients (41-59 ys: mean 51ys) with diabetic foot. They underwent diffusion weighted MR imaging of the foot using a single shot echo planar imaging with a b-factor of 0,500 & 1000 sec/mm2. The scanning parameters were: TR= 10000 ms, TE=108ms, NEX=8-16, bandwidth=125 kHz, slice thickness =4 mm. Apparent diffusion coefficient (ADC) map was reconstructed. The ADC value was calculated and correlated with surgical findings or biopsy. Statistical analysis was done.

The mean ADC value of diabetic osteoarthropathy was 0.97±0.13X 10-3 mm2/sec and of osteomyelitis was .121±0.12X10-3 mm2/sec. There was statistically difference in mean ADC values between diabetic osteoarthtopathy and osteomyelitis (p<0.01). When apparent diffusion coefficient value of 0.77X 10-3 mm2/sec was used as a threshold value for differentiating of diabetic osteoartrhopathy from osteomyelitis, the best result was obtained with an accuracy of 90%, sensitivity 92%, specificity 89%, positive predictive value 88% and negative predictive value of 86%.

we concluded that apparent diffusion coefficient value is a new non-invasive imaging parameter that can be used for differentiation of diabetic osteoarthropathy from osteomyelitis.

Diffusion weighted MR imaging can be added to routine MR imaging of diabetic foot.

Abdel Razek, A, Saad, E, Diffusion Weighted MR Imaging of Diabetic Foot.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026657.html