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Radiology Research and Practice
Volume 2017, Article ID 2761818, 7 pages
Research Article

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

1Radiology Department, University of Pavia, Pavia, Italy
2Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
3Unit of Internal Medicine and Endocrinology, IRCCS Salvatore Maugeri Foundation, Scientific Institute of Pavia, Pavia, Italy
4Neuroradiology Department, C. Mondino National Neurological Institute, Pavia, Italy
5Radiology Department, IRCCS Salvatore Maugeri Foundation, Scientific Institute of Pavia, Pavia, Italy
6Institute of Radiology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
7Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

Correspondence should be addressed to P. F. Felisaz; ti.liamtoh@lefluap

Received 12 August 2016; Accepted 29 November 2016; Published 16 April 2017

Academic Editor: Rod Scott

Copyright © 2017 P. F. Felisaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study was to assess with MRI morphometric ultrastructural changes in nerves affected by diabetic peripheral neuropathy (DPN). We used an MR micro-neurography imaging protocol and a semiautomated technique of tissue segmentation to visualize and measure the volume of internal nerve components, such as the epineurium and nerve fascicles. The tibial nerves of 16 patients affected by DPN and of 15 healthy volunteers were imaged. Nerves volume (NV), fascicles volume (FV), fascicles to nerve ratio (FNR), and nerves cross-sectional areas (CSA) were obtained. In patients with DPN the NV was increased and the FNR was decreased, as a result of an increase of the epineurium (FNR in diabetic neuropathy 0,665; in controls 0,699, ). CSA was increased in subjects with DPN (12,84 mm2 versus 10,22 mm2, ). The FV was increased in patients with moderate to severe DPN. We have demonstrated structural changes occurring in nerves affected by DPN, which otherwise are assessable only with an invasive biopsy. MR micro-neurography appears to be suitable for the study of microscopic changes in tibial nerves of diabetic patients.