Aim: This study is to investigate changes in microstructure in the calf muscles of patients with type 2 diabetes mellitus (DM) and foot ulcers.

Methods: 42 subjects were recruited: 14 without DM (WDM), 19 DM, and 9 DM and ulcer (DMU). They all underwent non-contrast diffusion imaging scans in a 3T MRI scanner, at rest and during a plantarflexion exercise with a fixed resistance.

Results: Reserve data (exercise/rest) of major diffusion indexes for medial gastrocnemius (MG) and soleus (SOL) were calculated for analysis. The indexes were: Fractional Anisotropy (FA), Mean Diffusivity (MD), primary eigenvalue λ1, fiber length, and fiber angle. Diffusional and fiber changes (P<.05) were evident for the MG muscle in the DM and DMU groups (larger diffusional reserve values and larger fiber loss were observed in the DMU group) compared to the WDM group (Figure 1). The DMU was the only group that showed statistically significant diffusional variations (reserve FA, MD, and λ1) for the SOL muscle (P<.05).

Conclusion: Diffusion imaging was able to identify DM associated muscle microstructure dysfunction in the calf.

M. Edalati: None. M. Hastings: None. C.J. Sorensen: None. M.J. Mueller: None. J. Zheng: Consultant; Self; KBI international.


National Institutes of Health

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