Hofmann W J, Forstner R
Department of Vascular Surgery, St Johns Hospital Salzburg, Austria.
Acta Chir Belg. 2002 Apr;102(2):92-6. doi: 10.1080/00015458.2002.11679273.
Diabetic macroangiopathy is associated with a typical disease pattern, mostly affecting the tibial but sparing the pedal arteries. Bypass grafts to these patent pedal vessels have evolved into a feasible technique. Restoring a palpable pulse in the ischemic foot they create the prerequisite to heal an ulcer or gangrene. Preoperative evaluation of pedal arteries demands a detailed depiction of the entire pedal vascular system. At present, the main options for preoperative pedal artery imaging are selective DSA contrast enhanced MRA and Duplex ultrasound. The aim of this review article is to give a survey of these three techniques and to determine their potential to depict pedal run off vessels. Selective DSA is still the standard diagnostic tool in preoperative pedal artery imaging. CE MRA offers high contrast related resolution but in-plane resolution is inferior to the concurrent imaging techniques. Duplex is the preferable method to evaluate a pedal artery's diameter and morphology. Both, CE MRA and Duplex are worthwhile additional imaging techniques in case DSA did not sufficiently depict the pedal vasculature.
糖尿病大血管病变具有典型的疾病模式，主要影响胫动脉而不累及足动脉。对这些通畅的足血管进行搭桥术已发展成为一种可行的技术。恢复缺血足部可触及的脉搏为治愈溃疡或坏疽创造了前提条件。术前对足动脉的评估需要详细描绘整个足部血管系统。目前，术前足动脉成像的主要选择是选择性数字减影血管造影（DSA）、对比增强磁共振血管造影（CE MRA）和双功超声。这篇综述文章的目的是对这三种技术进行概述，并确定它们描绘足部流出血管的潜力。选择性DSA仍然是术前足动脉成像的标准诊断工具。CE MRA提供了高对比分辨率，但平面分辨率低于同期成像技术。双功超声是评估足动脉直径和形态的首选方法。如果DSA不能充分描绘足部血管系统，CE MRA和双功超声都是值得采用的额外成像技术。
