Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8542, USA.
Department of Plastic Surgery, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA.
Int J Mol Sci. 2021 Oct 26;22(21):11552. doi: 10.3390/ijms222111552.
Diabetic foot infection is the leading cause of non-traumatic lower limb amputations worldwide. In addition, diabetes mellitus and sequela of the disease are increasing in prevalence. In 2017, 9.4% of Americans were diagnosed with diabetes mellitus (DM). The growing pervasiveness and financial implications of diabetic foot infection (DFI) indicate an acute need for improved clinical assessment and treatment. Complex pathophysiology and suboptimal specificity of current non-invasive imaging modalities have made diagnosis and treatment response challenging. Current anatomical and molecular clinical imaging strategies have mainly targeted the host's immune responses rather than the unique metabolism of the invading microorganism. Advances in imaging have the potential to reduce the impact of these problems and improve the assessment of DFI, particularly in distinguishing infection of soft tissue alone from osteomyelitis (OM). This review presents a summary of the known pathophysiology of DFI, the molecular basis of current and emerging diagnostic imaging techniques, and the mechanistic links of these imaging techniques to the pathophysiology of diabetic foot infections.
糖尿病足感染是全球非创伤性下肢截肢的主要原因。此外，糖尿病及其并发症的患病率也在不断上升。2017 年，9.4%的美国人被诊断患有糖尿病（DM）。糖尿病足感染（DFI）的普遍性和经济影响日益增加，这表明迫切需要改进临床评估和治疗。复杂的病理生理学和当前非侵入性成像方式的特异性不足，使得诊断和治疗反应具有挑战性。目前的解剖学和分子临床成像策略主要针对宿主的免疫反应，而不是入侵微生物的独特代谢。成像技术的进步有可能减少这些问题的影响，并改善 DFI 的评估，特别是在区分单纯软组织感染和骨髓炎（OM）方面。本综述总结了 DFI 的已知病理生理学、当前和新兴诊断成像技术的分子基础，以及这些成像技术与糖尿病足感染病理生理学的机制联系。
