While PI provides a faster snapshot of specific sites, whole-body MRI takes a broader view, and has recently shown its ability to assess risk of heart attack and stroke in diabetic patients. Fabian Bamberg, MD, MPH, of Ludwig Maximilian University of Munich, and colleagues designed a study aimed to establish the predictive value of whole-body MRI for the occurrence of cardiovascular and cerebrovascular events in a cohort of patients with diabetes mellitus (DM). The study was published online Sept. 10, 2013, in Radiology.
Diabetic patients are known to develop atherosclerosis, which is the thickening of the arterial walls at an accelerated rate. This can result in a higher rate of major adverse cardiac and cerebrovascular events (MACCE).
The authors followed up with phone interviews for 61 patients with DM types 1 and 2 who underwent comprehensive, contrast-enhanced whole-body MR imaging protocol, including brain, cardiac, and vascular sequences at baseline. The primary endpoint was a MACCE, such as composite cardiac-cerebrovascular death, myocardial infarction, cerebrovascular event, or revascularization. Fourteen of the 61 patients suffered a MACCE during the follow-up period.
MR images were assessed for the presence of systemic atherosclerotic vessel changes, white matter lesions, and myocardial changes. The researchers found that while subjects without any pathologic findings on whole-body MRI did not experience an event over the follow-up period, the risk for MACCE was substantially higher among diabetic patients with any finding on whole-body MRI. Among those, a cumulative event rate of 20 percent at three years and 35 percent at six years was demonstrated.
“This discovery shows that a comprehensive, whole-body MR acquisition provides accurate assessment of the underlying disease burden in patients with diabetes mellitus that has very relevant prognostic information,” says Bamberg. “Also, the prognostic value may be higher than only limited protocols, such as those tailored to the heart.”
Diabetic patients are known to develop atherosclerosis, which is the thickening of the arterial walls at an accelerated rate. This can result in a higher rate of major adverse cardiac and cerebrovascular events (MACCE).
The authors followed up with phone interviews for 61 patients with DM types 1 and 2 who underwent comprehensive, contrast-enhanced whole-body MR imaging protocol, including brain, cardiac, and vascular sequences at baseline. The primary endpoint was a MACCE, such as composite cardiac-cerebrovascular death, myocardial infarction, cerebrovascular event, or revascularization. Fourteen of the 61 patients suffered a MACCE during the follow-up period.
MR images were assessed for the presence of systemic atherosclerotic vessel changes, white matter lesions, and myocardial changes. The researchers found that while subjects without any pathologic findings on whole-body MRI did not experience an event over the follow-up period, the risk for MACCE was substantially higher among diabetic patients with any finding on whole-body MRI. Among those, a cumulative event rate of 20 percent at three years and 35 percent at six years was demonstrated.
“This discovery shows that a comprehensive, whole-body MR acquisition provides accurate assessment of the underlying disease burden in patients with diabetes mellitus that has very relevant prognostic information,” says Bamberg. “Also, the prognostic value may be higher than only limited protocols, such as those tailored to the heart.”
