Changes in Cartilage and Tendon Composition of Patients with Type i Diabetes Mellitus: Identification by Quantitative Sodium Magnetic Resonance Imaging at 7 T

Objective The aim of this study was to investigate possible biochemical alterations in tendons and cartilage caused by type 1 diabetes mellitus (DM1), using quantitative in vivo 7 T sodium magnetic resonance (MR) imaging. Materials and Methods The institutional review board approved this prospective study, and written informed consent was obtained. Eight DM1 patients with no history of knee trauma and 9 healthy age- and weight-matched volunteers were examined at 7 T using dedicated knee coils. All participants underwent morphological and sodium MR imaging. Region-of-interest analysis was performed manually for the non-weight-bearing area of the femoral condyle cartilage and for the patella tendon. Two readers read the image data sets independently, twice, for intrareader and interreader agreement. Normalized mean sodium signal intensity (NMSI) values were compared between patients and volunteers for each reader using analysis of variance. Results On morphological images, cartilage in the non-weight-bearing area and the patellar tendon was intact in all patients. On sodium MR imaging, bivariate analysis of variance showed significantly lower mean NMSI values in the cartilage (P = 0.008) and significantly higher values in the tendons (P = 0.025) of patients compared with those of volunteers. Conclusion Our study showed significantly different NMSI values between DM1 patients and matched volunteers. Differences observed in the cartilage and tendon might be associated with a DM1-related alteration of biochemical composition that occurs before it can be visualized on morphological MR sequences.