Application of microvascular imaging in evaluation of lower extremity arterial blood perfusion in patients with diabetes

doi:10.3877/cma.j.issn.1672-6448.2020.10.013

Abstract

Abstract:

Objective

To evaluate the application value of microvascular ultrasound imaging (MicroV) in the evaluation of lower extremity arterial blood perfusion in patients with diabetes.

Methods

Ninety-seven patients with diabetes and lower extremity arterial disease admitted to the Department of Endocrinology and Department of Vascular Surgery of the First Affiliated Hospital of Zhejiang University School of Medicine from November 2019 to March 2020 were selected as a case group, and 28 healthy volunteers during the same period were selected as a control group. The patients in the case group were divided into a non-arteriosclerosis occlusion (NLASO) subgroup (n=32) and an arteriosclerosis occlusion (LASO) subgroup (n=65). The LASO group was further divided into three sub-subgroups: Fontaine stage Ⅱ (limping stage; 24 cases), stage Ⅲ (resting pain stage; 21 cases), and stage Ⅳ (ulcer and gangrene stage; 20 cases).

Results

Compared with the control group and the NLASO subgroup, the inner diameter of the dorsal toe artery and the tiptoe artery in the LASO subgroup became thinner, the continuity was interrupted or lacking, and the color was not bright. The inner diameter and peak value of the dorsal toe artery and the tiptoe artery in the three sub-subgroups of the LASO subgroup were significantly lower than those in the control group and the NLASO group (P<0.05 for all). The inner diameter and peak value of the dorsal toe artery and the tiptoe artery in Fontaine stage Ⅲ and Ⅳsub-subgroups were significantly lower than those of Fontaine stage Ⅱ (stage Ⅲ vs stage Ⅱ: P=0.005, 0.003, 0.009, and 0.026; stage Ⅳ vs Ⅱ: P=0.001, 0.000, 0.001, and 0.000).

Conclusion

Microvascular imaging technology can dynamically reflect the perfusion of peripheral arteries in real time and perform quantitative analysis, thus providing a reference for clinical evaluation of the ischemia of peripheral arteries in patients with diabetic lower extremity arterial disease.

Key words: Diabetes complications, Ultrasonography, Microvascular imaging, Peripheral vessel

Jialin Qiang, Tian’an Jiang, Xiujing Xie. Application of microvascular imaging in evaluation of lower extremity arterial blood perfusion in patients with diabetes[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(10): 1006-1010.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.10.013

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I10/1006

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References 17

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组别	例数	性别[男性，例（%）]	吸烟[例（%）]	年龄（岁，±s）	BMI（㎏/m²，±s）	FBG（ mmol /L，±s）	HbA1c（%，±s）
对照组	28	16（57.1）	9（32.1）	58.14±11.98	23.38±3.09	5.01±0.52	5.07±0.74
病例组	97	58（59.8）	44（45.4）	62.58±13.15	24.32±2.59	9.70±2.99	9.60±2.22
统计值	?	χ²=0.001	χ²=1.060	t=-1.60	t=-1.63	t=-14.59	t=-17.02
P值	?	0.974	0.303	0.112	0.107	0.000	0.000

组别	例数	性别[男性，例（%）]	吸烟[例（%）]	年龄（岁，±s）	BMI（㎏/m²，±s）	FBG（ mmol /L，±s）	HbA1c（%，±s）
对照组	28	16（57.1）	9（32.1）	58.14±11.98	23.38±3.09	5.01±0.52	5.07±0.74
病例组	97	58（59.8）	44（45.4）	62.58±13.15	24.32±2.59	9.70±2.99	9.60±2.22
统计值	?	χ²=0.001	χ²=1.060	t=-1.60	t=-1.63	t=-14.59	t=-17.02
P值	?	0.974	0.303	0.112	0.107	0.000	0.000

组别		例数	趾背动脉		趾尖动脉
组别		例数	内径（mm）	峰值（%）	内径（mm）	峰值（%）
对照组		28	0.71（0.66，0.78）^a	41.45（33.23，56.53）^a	0.60（0.54，0.65）^a	14.25（10.58，16.95）^a
非动脉硬化闭塞组		32	0.61（0.55，0.72）^b	37.20（27.75，47.33）^b	0.56（0.50，0.60 ）^b	14.15（7.33，20.83）^b
动脉硬化闭塞组		?	?	?	?	?
?	Fontaine Ⅱ期亚组	24	0.51（0.44，0.62）^c	24.20（15.73，40.08）^c	0.47（0.40，0.55）^c	7.40（4.60，10.30）^c
?	Fontaine Ⅲ期亚组	21	0.39（0.35，0.48）	15.60（9.10，21.15）	0.35（0.34，0.43）	3.3（1.90，5.90）
?	Fontaine Ⅳ期亚组	20	0.38（0.08，0.44）	12.80（4.75，17.88）	0.10（0，0.39）	0（0，1.63）
Z值		?	80.793	84.701	69.411	73.838
P值		?	<0.001	<0.001	<0.001	<0.001

组别		例数	趾背动脉		趾尖动脉
组别		例数	内径（mm）	峰值（%）	内径（mm）	峰值（%）
对照组		28	0.71（0.66，0.78）^a	41.45（33.23，56.53）^a	0.60（0.54，0.65）^a	14.25（10.58，16.95）^a
非动脉硬化闭塞组		32	0.61（0.55，0.72）^b	37.20（27.75，47.33）^b	0.56（0.50，0.60 ）^b	14.15（7.33，20.83）^b
动脉硬化闭塞组		?	?	?	?	?
?	Fontaine Ⅱ期亚组	24	0.51（0.44，0.62）^c	24.20（15.73，40.08）^c	0.47（0.40，0.55）^c	7.40（4.60，10.30）^c
?	Fontaine Ⅲ期亚组	21	0.39（0.35，0.48）	15.60（9.10，21.15）	0.35（0.34，0.43）	3.3（1.90，5.90）
?	Fontaine Ⅳ期亚组	20	0.38（0.08，0.44）	12.80（4.75，17.88）	0.10（0，0.39）	0（0，1.63）
Z值		?	80.793	84.701	69.411	73.838
P值		?	<0.001	<0.001	<0.001	<0.001

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