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Projekt DiaNerve – Tidlig Opsporing af Nerveskade giver ny Viden og forebygger Amputationer

Projekt DiaNerve – Tidlig Opsporing af Nerveskade giver ny Viden og forebygger Amputationer. Velfærdsløftet er lige om hjørnet København den 23. oktober 2013. Niels Ejskjær MD PhD Klinisk Forskning og Fundraising.

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Projekt DiaNerve – Tidlig Opsporing af Nerveskade giver ny Viden og forebygger Amputationer

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  1. Projekt DiaNerve – Tidlig Opsporing af Nerveskade giver ny Viden og forebygger Amputationer Velfærdsløftet er lige om hjørnet København den 23. oktober 2013 Niels Ejskjær MD PhD Klinisk Forskning og Fundraising

  2. PLATFORMFondsgiver UNIK PartnerskabetTeknologi Siemens A/S Health Sector DKRegnskab Aarhus UniversitetForskning Dansk Diabetes Akademi Klinik Aarhus Universitetshospital Data-analyse Aalborg Universitet Rådgivning Odense Universitetshospital

  3. Type 1 Diabetes

  4. Type 2 Diabetes

  5. Diabetes i Danmark • T1D: 25.000 • T2D: 300.000 diagnostiserede • T2D: 200.000 ikke-diagnostiserede • T2D: 250.000 forstadier • T2D: 750.000?

  6. 23.000 nye tilfælde / år 64 nye tilfælde / dag Type 2 diabetes

  7. 1 af 7 diabetikere får et fodsår

  8. 1000 større amputationer i DK årligt 500 amputationer kunne undgås

  9. Nedsat følesans er den stærkeste risikofaktor for fodsår og amputation

  10. Undersøgelser nerver Følesans Let berøring Smerte Vibrationssans Nerveledningshastighed Nervebiopsi Ultralyd MR-scanning

  11. Nervefibre

  12. Peripheral nerve [1]A.G. Filler et al Neurol Clin 2004

  13. Methodology Patients and controls 4 type II diabetic patients with polyneuropathy (DPN) 2 type II diabetic patients (nDPN) without neuropathy 4 healthy control (HC) subjects. T2w SPAIR (0.6x0.6x3mm), 3Tesla Presence of neuropathy was determined based on the clinical examination • Neuropathy impairment score • Neuropathy symptom score and nerve conduction studies

  14. MR Neurography • T2w MR imaging of the hyperintense low-protein endoneurialfluid • Suppression of fat signal around nerves and from within nerves • Image resolution < 0.6x0.6mm • High quality surface coils [1] M. Pham et al. Diabetes Care 2011

  15. Results A B T2w SPAIR MRI A) Diabetic patient with severe neuropathy B) Diabetic patient without neuropathy

  16. Results Kruskal–Wallis one-way analysis of variance

  17. Konklusion MR-scanning viste en signifikant øgning I volumen af nervus ischiadicus hos patienter med diabetisk nervesygdom MR-scanning af hele nervesystemet er mulig (total nerve lesion load) MR-scanning kan anvendes til dybtliggende nervestrukturer

  18. Tak

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