title: Whole-Body MR Imaging Including Angiography: Predicting Recurrent Events in Diabetics.
abstract: OBJECTIVE
  Whether whole-body MRI can predict occurrence of recurrent events in patients with diabetes mellitus.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Whole-body MR findings predict occurrence of recurrent events in diabetics independent of clinical characteristics, and may concurrently provide organ system-specific risk.
  
  
  CONCLUSIONS
  • 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.
authors: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Robert C
authors: RC
authors: Bertheau
authors: Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany. fabian.bamberg@med.uni-muenchen.de.|Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany. fabian.bamberg@med.uni-muenchen.de.
authors: Fabian
authors: F
authors: Bamberg
authors: Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany.
authors: Elena
authors: E
authors: Lochner
authors: Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany.
authors: Hannes M
authors: HM
authors: Findeisen
authors: Department of Internal Medicine II, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany.
authors: Klaus G
authors: KG
authors: Parhofer
authors: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Hans-Ulrich
authors: HU
authors: Kauczor
authors: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
authors: Stefan O
authors: SO
authors: Schoenberg
authors: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Sabine
authors: S
authors: Weckbach
authors: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Christopher L
authors: CL
authors: Schlett
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000473:pathology*; D016893:Carotid Stenosis / Q000473:pathology; D003324:Coronary Artery Disease / Q000473:pathology; D003925:Diabetic Angiopathies / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology*; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D051598:Whole Body Imaging / Q000379:methods
keywords: Anatomical relatedness; Diabetes mellitus; Prediction; Recurrent events; Whole-body magnetic resonance imaging