Gatt Alfred, Falzon Owen, Cassar Kevin, Camilleri Kenneth P, Gauci Jean, Ellul Christian, Mizzi Stephen, Mizzi Anabelle, Papanas Nikolaos, Sturgeon Cassandra, Chockalingam Nachiappan, Formosa Cynthia
1 University of Malta, Misda, Malta.
2 Democritus University of Thrace, Alexandroupolis, Greece.
Int J Low Extrem Wounds. 2018 Jun;17(2):102-105. doi: 10.1177/1534734618783910. Epub 2018 Jun 27.
This study aimed to determine whether thermal imaging can detect temperature differences between healthy feet, nonulcerated neuroischemic feet, and neuroischemic feet with toe ulcers in patients with type 2 diabetes mellitus (T2DM). Participants were prospectively divided into 3 groups: T2DM without foot problems; a healthy, nonulcerated neuroischemic group, and an ulcerated neuroischemic group. Thermal images of the feet were obtained with automated segmentation of regions of interest. Thermographic images from 43 neuroischemic feet, 21 healthy feet, and 12 neuroischemic feet with active ulcer in one of the toes were analyzed. There was a significant difference in toe temperatures between the 3 groups ( P = .001), that is, nonulcerated neuroischemic (n = 181; mean temperature = 27.7°C [±2.16 SD]) versus neuroischemic ulcerated (n = 12; mean temperature = 28.7°C [±3.23 SD]), and healthy T2DM group (n = 104; mean temperature = 24.9°C [±5.04 SD]). A post hoc analysis showed a significant difference in toe temperatures between neuroischemic nonulcerated and healthy T2DM groups ( P = .001), neuroischemic ulcerated and healthy groups ( P = .001). However, no significant differences in toe temperatures were identified between the ulcerated neuroischemic and nonulcerated neuroischemic groups ( P = .626). There were no significant differences between the ulcerated toes (n = 12) and the nonulcerated toes (n = 57) of the same foot in the ulcerated neuroischemic group ( P = .331). Toe temperatures were significantly higher in neuroischemic feet with or without ulceration compared with healthy feet in patients with T2DM. There were no significant differences in temperatures of ulcerated toes and the nonulcerated toes of the same foot, implying that all the toes of the same foot could potentially be at risk of developing complications, which can be potentially detected by infrared thermography.
本研究旨在确定热成像是否能够检测2型糖尿病（T2DM）患者中健康足部、无溃疡的神经缺血性足部以及伴有趾溃疡的神经缺血性足部之间的温度差异。参与者被前瞻性地分为3组：无足部问题的T2DM患者；健康、无溃疡的神经缺血组；以及溃疡型神经缺血组。通过自动分割感兴趣区域获得足部的热图像。分析了43只神经缺血性足部、21只健康足部以及12只其中一个趾部有活动性溃疡的神经缺血性足部的热成像图像。3组之间的趾温度存在显著差异（P = 0.001），即无溃疡的神经缺血性足部（n = 181；平均温度 = 27.7°C [±2.16标准差]）与神经缺血性溃疡足部（n = 12；平均温度 = 28.7°C [±3.23标准差]），以及健康T2DM组（n = 104；平均温度 = 24.9°C [±5.04标准差]）。事后分析显示，神经缺血性无溃疡组与健康T2DM组之间的趾温度存在显著差异（P = 0.001），神经缺血性溃疡组与健康组之间也存在显著差异（P = 0.001）。然而，溃疡型神经缺血组与无溃疡的神经缺血组之间的趾温度未发现显著差异（P = 0.626）。溃疡型神经缺血组中同一足部的溃疡趾（n = 12）与无溃疡趾（n = 57）之间也无显著差异（P = 0.331）。与T2DM患者的健康足部相比，有或无溃疡的神经缺血性足部的趾温度显著更高。同一足部的溃疡趾与无溃疡趾的温度无显著差异，这意味着同一足部的所有趾都可能有发生并发症的风险，而这可以通过红外热成像潜在地检测出来。
