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Non-contrast MRI perfusion angiosome in diabetic feet

  • Magnetic Resonance
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Abstract

Objective

The purpose of this study is to develop a non-contrast magnetic resonance imaging (MRI) approach to evaluate skeletal muscle perfusion in the diabetic foot based on the concept of angiosomes of the foot.

Methods

Five healthy volunteers and five participants with diabetes (HbA1c = 7.2 ± 1.8 %) without a history of peripheral artery disease were examined. The non-contrast perfusion measurements were performed during a toe flexion challenge. Absolute perfusion maps were created and two regions (medial and lateral) on the maps were segmented based on angiosomes.

Result

Regional difference in the perfusion of foot muscle was readily visualized in the MRI perfusion angiosomes during the challenge. In the participants with diabetes, the perfusion during toe flexion challenge was significantly lower than in healthy volunteers (P < 0.01). The average perfusion for the medial plantar region of the right foot was lower in subjects with diabetes (38 ± 9 ml/min/100 g) than in healthy subjects (93 ± 33 ml/min/100 g).

Conclusions

Non-contrast MRI perfusion angiosome maps demonstrate the feasibility of determining regional perfusion in foot muscles during toe challenge and may facilitate evaluation of muscle perfusion in diabetic feet.

Key Points

• Non-contrast MRI perfusion angiosome maps measure regional perfusion in foot muscles non-invasively.

• Foot perfusion response to challenge is reduced in persons with diabetes.

• MRI perfusion angiosome maps may help evaluation of regional foot muscle perfusion.

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Acknowledgments

Research reported in this publication was supported partially by the Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH), a research grant from Diabetes Action Research and Education Foundation, and the Mallinckrodt Institute of Radiology. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH. The authors thank Darrah Snozek for assistance in subject recruitment.

The scientific guarantor of this publication is Jie Zheng. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. No complex statistical methods were necessary for this paper. Washington University in St. Louis Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, Cardiovascular Imaging Lab, 510 South Kingshighway Blvd. Campus Box 8225, St. Louis, MO, 63110, USA

    Jie Zheng

  2. The Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Mary K. Hastings & Michael J. Mueller

  3. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA

    David Muccigross & Charles F. Hildebolt

  4. The Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    John Curci

  5. Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Zhaoyang Fan

  6. Department of Radiology, West China Hospital, Sichuan University, Chengdu, China

    Fabao Gao

Authors
  1. Jie Zheng
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  2. Mary K. Hastings
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  4. Zhaoyang Fan
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Correspondence to Jie Zheng.

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Zheng, J., Hastings, M.K., Muccigross, D. et al. Non-contrast MRI perfusion angiosome in diabetic feet. Eur Radiol 25, 99–105 (2015). https://doi.org/10.1007/s00330-014-3337-0

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  • DOI: https://doi.org/10.1007/s00330-014-3337-0

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