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| Feasibility of dynamic contrast-enhanced CT in evaluating perfusion of diabetic patients’ plantar soft tissue |
| DU Mei, NI Jian-ming, XU Hui-ting, HUA Dong-ying, ZHANG Zhui-yang |
| Department of Radiology, Wuxi No.2 People’s Hospital, Affiliated Hospital of
Nanjing Medical University, Wuxi Jiangsu 214002, China |
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Abstract Objective: To prospectively investigate the feasibility and repeatability of multi-slice spiral computed tomography(MDCT) in the quantitative evaluation of perfusion of plantar soft tissue in patients with diabetic and to analyze the microcirculation perfusion characteristics of diabetic foot soft tissue. Methods: Institutional review board approval and informed patient consent were obtained. Thirteen patients with diabetes mellitus(9 males and 4 females; mean age 63.5±11 years, range 40~77) were prospectively included. All patients underwent CTA to make a definite diagnosis and were classified into abnormal group(12) and normal group(14) as having major vascular lesions according to CTA. A Toshiba 320-row spiral CT(Aquilion ONE) was used with acquisition of dynamic volume perfusion of double-sided foot. Time density curve(TDC), blood flow(BF), blood volume(BV), mean transit time(MTT) and time to peak(TTP) of skeletal muscle in normal or abnormal foot were obtained with perfusion software． Results: CT perfusion scans of lower extremities were performed in all patients. Thirteen patients completed the examination successfully. The TDC parameters(BF, BV, MTT and TTP) of the diabetic foot were measured. The abnormal group and normal group respectively were (21.1±12.3) mL/(100 mg·min) vs (34.8±20.2) mL/(100 mg·min), (1.7±0.6) mL/100 g vs (1.8±0.7) mL/100 g, (5.9±1.9) s vs (3.8±1.9) s, (55.5±16.6) s vs (38.9±15.6) s. Good inter-observer and intra-observer agreement was obtained in all patients. By comparing perfusion parameters for normal foot, a significantly longer MTT and TTP was obtained. Conclusion: CT perfusion of the foot is a feasible and reproducible technique that can assess the level of microcirculation in the plantar soft tissue and can prompt the existence of early skeletal muscle ischemia for patients with diabetic foot． The method can be valuable for clinical early diagnosis．
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Received: 17 April 2018
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