Wen Xiao-Rong, Lü Xia-Fei, Liu Chun-Cheng, Luo Yan, Chen Da-Wei, Wang Chun, Ran Xing-Wu
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 Sep;43(5):739-42.
To identify the ultrasound image characteristics of lower limb arteries in diabetic feet.
189 patients with diabetic feet were recruited in this study. 375 lower limbs of the patients were classified into grade I-IV according to their Fontaine classifications and accepted Color Doppler Ultrasound examinations. Of the 375 lower limbs, 210 were classified as level I, 46 as level II, 43 as level III and 76 as level IV. The degree of artery stenosis was categorized into < or = 50% reduction in diameter, 51%-99% reduction in diameter and complete occlusion. The lesion characteristics of common femoral arteries, superficial femoral arteries, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries and dorsalis pedis arteries were analyzed. The ultrasound scores of lower limbs arterial diseases were compared in the patients with different levels of Fontaine classifications.
The incidence of plagues in lower extremities arteries was 97.60% (366/375). Most plaques (97.60%, 366/375) were distributed in crus arteries and the majority of plaques (59.47%, 223/375) were serious. The incidence of PAD was 63.73% (239/375). Crus vasculars involvement was more serious. The levels of Fontaine classifications of the lower limb arteries were associated with ultrasound vascular disease severity scores. The higher grade had higher scores. The lower limbs with at least one occlusive blood vessel in the patients with Fontaine grade I reached 30%.
The Ultrasound image is an important screening tool for PAD in diabetic feet. It can estimate the type of plaques, the seriousness of artery diseases and the location of lesions. Because up to 30% diabetic feet with Fontaine I classifications have at least one occlusive blood vessel, the clinical manifestations do not provide enough evidence for the diagnosis of PAD.
明确糖尿病足下肢动脉的超声图像特征。
本研究纳入189例糖尿病足患者。将患者的375条下肢根据Fontaine分级分为I - IV级,并接受彩色多普勒超声检查。在这375条下肢中,210条为I级,46条为II级,43条为III级,76条为IV级。动脉狭窄程度分为直径减少≤50%、直径减少51% - 99%和完全闭塞。分析股总动脉、股浅动脉、腘动脉、胫前动脉、胫后动脉、腓动脉和足背动脉的病变特征。比较不同Fontaine分级患者下肢动脉疾病的超声评分。
下肢动脉斑块发生率为97.60%(366/375)。大多数斑块(97.60%,366/375)分布在小腿动脉,且大多数斑块(59.47%,223/375)为重度。外周动脉疾病(PAD)发生率为63.73%(239/375)。小腿血管受累更严重。下肢动脉的Fontaine分级与超声血管疾病严重程度评分相关。分级越高,评分越高。Fontaine I级患者中至少有一条闭塞血管的下肢达30%。
超声图像是糖尿病足PAD的重要筛查工具。它可以评估斑块类型、动脉疾病的严重程度和病变部位。由于高达30%的Fontaine I级糖尿病足至少有一条闭塞血管,临床表现不足以作为PAD诊断依据。