MR Micro-Neurography and a Segmentation Protocol Applied to Diabetic Neuropathy

Area of Science:

• Neurology
• Radiology
• Diabetology

Background:

• Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus.
• DPN affects nerve structure and function, leading to significant morbidity.
• Current diagnostic methods for DPN often lack sensitivity to early structural changes.

Purpose of the Study:

• To assess morphometric ultrastructural nerve changes in DPN using MR micro-neurography.
• To quantify internal nerve component volumes and cross-sectional areas in DPN patients.
• To evaluate the utility of MR micro-neurography for non-invasive DPN assessment.

Main Methods:

• MR micro-neurography imaging protocol applied to tibial nerves.
• Semiautomated tissue segmentation for measuring epineurium and fascicle volumes.
• Comparison of nerve volume (NV), fascicle volume (FV), fascicle-to-nerve ratio (FNR), and cross-sectional area (CSA) between DPN patients and healthy controls.

Main Results:

• DPN patients exhibited increased nerve volume (NV) and cross-sectional area (CSA).
• A decreased fascicle-to-nerve ratio (FNR) was observed in DPN, attributed to epineural thickening.
• Increased fascicle volume (FV) was noted in moderate to severe DPN cases.

Conclusions:

• MR micro-neurography effectively visualizes and quantifies structural nerve alterations in DPN.
• This non-invasive technique offers a valuable alternative to invasive nerve biopsy for DPN evaluation.
• MR micro-neurography shows promise for studying microscopic changes in diabetic tibial nerves.