Diffusion-weighted magnetic resonance imaging in the pancreas of fulminant type 1 diabetes

Abstract

Abrupt disease onset and severe metabolic disorders are main characteristics of fulminant type 1 diabetes. Diffusionweighted magnetic resonance imaging (DWI) is an imaging technique that reflects restricted diffusion in organs and can detect mononuclear cell infiltration into the pancreas at the onset of the disease. Fourteen patients with fulminant type 1 diabetes who underwent abdominal magnetic resonance imaging were recruited for the measurement of apparent diffusion coefficient (ADC) values of the pancreas that were compared with those of 21 non-diabetic controls. The ADC values of all parts of the pancreas were significantly lower in fulminant type 1 diabetes than in controls (head, 1.424 ± 0.382 × 10 −3

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“…MRI revealed that the size of the pancreas did not change between Days 8 and 50 after the onset. However, MRI showed higher ADC values at Day 50 than at Day 8, which corroborated with the results of previous studies on fulminant type 1 diabetes 14 …”

“…Oikawa et al showed a negative correlation between time from the onset of premonitory symptoms to diagnosis and anti-GAD antibody levels in GAD-positive fulminant type 1 diabetes. 13 The patient in the present study showed more rapid onset of GAD-positive fulminant type 1 diabetes (4.4 days earlier than that in the national survey results) 6 and was hospitalized approximately 24 h after the onset of premonitory symptoms. Nevertheless, GAD antibodies remained moderately positive (44.6 IU/L), and the results were not consistent with those of previous studies.…”

“…However, MRI showed higher ADC values at Day 50 than at Day 8, which corroborated with the results of previous studies on fulminant type 1 diabetes. 14 …”

“…Tokunaga et al reported that ADC values, which are calculated from diffusion‐weighted MRI (DWI), are low in all parts of the pancreas early in fulminant type 1 diabetes and increase over time, making ADC values a useful additional tool for diagnosing fulminant type 1 diabetes 14 . MRI revealed that the size of the pancreas did not change between Days 8 and 50 after the onset.…”