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应用灌注式 CT 血管造影术对糖尿病足患者的血管内治疗进行术中评估:概念性论文。

Use of perfusional CBCT imaging for intraprocedural evaluation of endovascular treatment in patients with diabetic foot: a concept paper.

机构信息

Division of Radiology, IEO European institute of oncology IRCCS, Milan, Italy.

Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy Via Festa del Perdono 7, 20122, Milan, Italy.

出版信息

Acta Biomed. 2020 Sep 23;91(10-S):e2020008. doi: 10.23750/abm.v91i10-S.10267.

Abstract

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide; its global burden has increased rapidly over the past decade, enough to be considered a public health emergency in many countries. Diabetic foot disease and, particularly diabetic foot ulceration, is the major complication of DM: through a skin damage of the foot, with a loss of epithelial tissue, it can deepen to muscles and bones and lead to the amputation of the lower limbs. Peripheral arterial disease (PAD) in patients with diabetes, manifests like a diffuse macroangiopathic multi-segmental involvement of the lower limb vessels, also connected to a damage of collateral circulation; it may also display characteristic microaneurysms and tortuosity in distal arteries. As validation method, Bold-MRI is used. The diabetic foot should be handled with a multidisciplinary team approach, as its management requires systemic and localized treatments, pain control, monitoring of cardiovascular risk factors and other comorbidities. CBCT is an emerging medical imaging technique with the original feature of divergent radiation, forming a cone, in contrast with the spiral slicing of conventional CT, and has become increasingly important in treatment planning and diagnosis: from small anatomical areas, such as implantology, to the world of interventional radiology, with a wide range of applications: as guidance for biopsies or ablation treatments. The aim of this project is to evaluate the usefulness of perfusion CBCT imaging, obtained during endovascular revascularization, for intraprocedural evaluation of endovascular treatment in patients with diabetic foot.

摘要

糖尿病(DM)是全球最常见的代谢疾病之一;在过去十年中,其全球负担迅速增加,足以在许多国家被视为公共卫生紧急情况。糖尿病足病,特别是糖尿病足溃疡,是 DM 的主要并发症:通过脚部皮肤损伤,失去上皮组织,它可以加深到肌肉和骨骼,并导致下肢截肢。糖尿病患者的外周动脉疾病(PAD)表现为下肢血管弥漫性大血管多节段受累,也与侧支循环损伤有关;它还可能在远端动脉显示出特征性的微动脉瘤和迂曲。作为验证方法,使用 Bold-MRI。糖尿病足应采用多学科团队方法进行处理,因为其管理需要全身和局部治疗、疼痛控制、心血管危险因素和其他合并症的监测。CBCT 是一种新兴的医学成像技术,具有辐射发散的原始特征,形成一个锥体,与传统 CT 的螺旋切片形成对比,在治疗计划和诊断中变得越来越重要:从小的解剖区域,如植入物,到介入放射学领域,应用广泛:作为活检或消融治疗的指导。本项目旨在评估血管内再血管化过程中获得的灌注 CBCT 成像在糖尿病足患者血管内治疗的术中评估中的有用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/8023083/4d97ff9eda3e/ACTA-91-08-g001.jpg

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