Mallinckrodt Institute of Radiology, Cardiovascular Imaging Lab, 510 South Kingshighway Blvd. Campus Box 8225, St. Louis, MO, 63110, USA,
Eur Radiol. 2015 Jan;25(1):99-105. doi: 10.1007/s00330-014-3337-0. Epub 2014 Aug 7.
The purpose of this study is to develop a non-contrast magnetic resonance imaging (MRI) approach to evaluate skeletal muscle perfusion in the diabetic foot based on the concept of angiosomes of the foot.
Five healthy volunteers and five participants with diabetes (HbA1c = 7.2 ± 1.8%) without a history of peripheral artery disease were examined. The non-contrast perfusion measurements were performed during a toe flexion challenge. Absolute perfusion maps were created and two regions (medial and lateral) on the maps were segmented based on angiosomes.
Regional difference in the perfusion of foot muscle was readily visualized in the MRI perfusion angiosomes during the challenge. In the participants with diabetes, the perfusion during toe flexion challenge was significantly lower than in healthy volunteers (P < 0.01). The average perfusion for the medial plantar region of the right foot was lower in subjects with diabetes (38 ± 9 ml/min/100 g) than in healthy subjects (93 ± 33 ml/min/100 g).
Non-contrast MRI perfusion angiosome maps demonstrate the feasibility of determining regional perfusion in foot muscles during toe challenge and may facilitate evaluation of muscle perfusion in diabetic feet.
• Non-contrast MRI perfusion angiosome maps measure regional perfusion in foot muscles non-invasively. • Foot perfusion response to challenge is reduced in persons with diabetes. • MRI perfusion angiosome maps may help evaluation of regional foot muscle perfusion.
本研究旨在基于足部血管分布区的概念，开发一种非对比磁共振成像（MRI）方法来评估糖尿病足的骨骼肌灌注。
对 5 名健康志愿者和 5 名无外周动脉疾病病史的糖尿病患者（HbA1c=7.2±1.8%）进行检查。在足趾弯曲挑战期间进行非对比灌注测量。创建绝对灌注图，并根据血管分布区将图上的两个区域（内侧和外侧）分割。
在挑战期间，MRI 灌注血管分布区可清晰显示足部肌肉的灌注区域差异。在糖尿病患者中，与健康志愿者相比，足趾弯曲挑战时的灌注明显较低（P<0.01）。与健康受试者（93±33ml/min/100g）相比，糖尿病患者（38±9ml/min/100g）右侧足底内侧区域的平均灌注较低。
非对比 MRI 灌注血管分布区图表明，在足趾挑战期间确定足部肌肉区域灌注是可行的，可能有助于评估糖尿病足的肌肉灌注。
• 非对比 MRI 灌注血管分布区图可无创测量足部肌肉的区域灌注。
• 糖尿病患者的足部灌注对挑战的反应降低。
• MRI 灌注血管分布区图可能有助于评估足部肌肉的区域灌注。
