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- Title
Whole-Body MR Imaging Including Angiography: Predicting Recurrent Events in Diabetics.
- Authors
Bertheau, Robert; Bamberg, Fabian; Lochner, Elena; Findeisen, Hannes; Parhofer, Klaus; Kauczor, Hans-Ulrich; Schoenberg, Stefan; Weckbach, Sabine; Schlett, Christopher; Bertheau, Robert C; Findeisen, Hannes M; Parhofer, Klaus G; Schoenberg, Stefan O; Schlett, Christopher L
- Abstract
<bold>Objectives: </bold>Whether whole-body MRI can predict occurrence of recurrent events in patients with diabetes mellitus.<bold>Methods: </bold>Whole-body MRI was prospectively applied to 61 diabetics and assessed for arteriosclerosis and ischemic cerebral/myocardial changes. Occurrence of cardiocerebral events and diabetic comorbidites was determined. Patients were stratified whether no, a single or recurrent events arose. As a secondary endpoint, events were stratified into organ system-specific groups.<bold>Results: </bold>During a median follow-up of 70 months, 26 diabetics developed a total of 39 events; 18 (30%) developed one, 8 (13%) recurrent events. Between diabetics with no, a single and recurrent events, a stepwise higher burden was observed for presence of left ventricular (LV) hypo-/akinesia (3/28/75%, p < 0.0001), myocardial delayed-contrast-enhancement (17/33/63%, p = 0.001), carotid artery stenosis (11/17/63%, p = 0.005), peripheral artery stenosis (26/56/88%, p = 0.0006) and vessel score (1.00/1.30/1.76, p < 0.0001). After adjusting for clinical characteristics, LV hypo-/akinesia (hazard rate ratio = 6.57, p < 0.0001) and vessel score (hazard rate ratio = 12.29, p < 0.0001) remained independently associated. Assessing organ system risk, cardiac and cerebral MR findings predicted more strongly events in their respective organ system. Vessel-score predicted both cardiac and cerebral, but not non-cardiocerebral, events.<bold>Conclusion: </bold>Whole-body MR findings predict occurrence of recurrent events in diabetics independent of clinical characteristics, and may concurrently provide organ system-specific risk.<bold>Key Points: </bold>• Patients with long-standing diabetes mellitus are at high risk for recurrent events. • Whole-body MRI predicts occurrence of recurrent events independently of clinical characteristics. • The vessel score derived from whole-body angiography is a good general risk-marker. • Whole-body MRI may also provide organ-specific risk assessment. • Current findings may indicate benefits of whole-body MRI for risk stratification.
- Subjects
MAGNETIC resonance imaging; MAGNETIC resonance angiography; PEOPLE with diabetes; DISEASE relapse; DIABETES; ARTERIOSCLEROSIS; RISK assessment; CEREBRAL arteriosclerosis; CEREBRAL ischemia; COMPARATIVE studies; CORONARY disease; DIABETIC angiopathies; DIAGNOSTIC imaging; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research; CAROTID artery stenosis; EARLY diagnosis
- Publication
European Radiology, 2016, Vol 26, Issue 5, p1420
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3936-4