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The Clinical Value of Diffusion Weighted Magnetic Resonance Imaging in Diabetic Foot Infection.

BACKGROUND
Osteomyelitis is a common complication in the diabetic foot which can be concluded with amputation. The purpose of this study was to evaluate the role of diffusion-weighted MRI (DWI) in the diagnosis of osteomyelitis in the diabetic foot ulcer (DFU).


METHODS
Thirty patients with type 2 diabetes mellitus having DFU were enrolled. DWI and conventional MRI were obtained. Apparent Diffusion Coefficient (ADC) measurements were made by transferring the images to the workstation. The measurements were made from a total of three points of the osteomyelitis or nearest bone to injury area and adjacent soft tissue.


RESULTS
Our patients comprised 9 (30%) females and 21 (70%) males of mean age 58.7 years (range, 41-78 years). The levels of ADC were significantly low and ESR were significantly high in group 1 (patients with osteomyelitis; n=9) when compared to the group 2 (patients without osteomyelitis; n=11) (p=0.022 and p=0.014, respectively). Mean bone ADC value was statistically lower than adjacent soft tissue ADC value in group 1 (0.75±0.16 x 10-3 mm2/s and 0.90±0.15 x 10-3 mm2/s, respectively; p=0.04).


CONCLUSION
It is suggested that DWI contributes to conventional MRI with short imaging time and no requirement of contrast agent. Therefore, DWI may be an alternative diagnostic method for evaluation of DFU and detection of osteomyelitis.