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Bertheau, Robert C.; Bamberg, Fabian; Lochner, Elena; Findeisen, Hannes M.; Parhofer, Klaus G.; Kauczor, Hans-Ulrich; Schoenberg, Stefan O.; Weckbach, Sabine and Schlett, Christopher L. (2016): Whole-Body MR Imaging Including Angiography: Predicting Recurrent Events in Diabetics. In: European Radiology, Vol. 26, No. 5: pp. 1420-1430

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Abstract

Whether whole-body MRI can predict occurrence of recurrent events in patients with diabetes mellitus. 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. 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. Whole-body MR findings predict occurrence of recurrent events in diabetics independent of clinical characteristics, and may concurrently provide organ system-specific risk. aEuro cent Patients with long-standing diabetes mellitus are at high risk for recurrent events. aEuro cent Whole-body MRI predicts occurrence of recurrent events independently of clinical characteristics. aEuro cent The vessel score derived from whole-body angiography is a good general risk-marker. aEuro cent Whole-body MRI may also provide organ-specific risk assessment. aEuro cent Current findings may indicate benefits of whole-body MRI for risk stratification.

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