Oximetric angiosome imaging in diabetic feet

Abstract

Purpose To develop a noncontrast oximetric angiosome imaging approach to assess skeletal muscle oxygenation in diabetic feet. Materials and Methods In four healthy and five subjects with diabetes, the feasibility of foot oximetry was examined using a 3T clinical magnetic resonance imaging (MRI) scanner. The subjects’ feet were scanned at rest and during a toe-flexion isometric exercise. The oxygen extraction fraction of skeletal muscle was measured using a susceptibility-based MRI method. Our newly developed MR foot oximetric angiosome model was compared with the traditional angiosome model in the assessment of the distribution of oxygen extraction fraction. Results Using the traditional angiosome during the toe-flexion exercise, the oxygen extraction fraction in the medial foot of healthy subjects increased (4.9 ± 3%) and decreased (−2.7 ± 4.4%) in subjects with diabetes (difference = 7.6%; 95% confidence interval = −13.7 ± 1.4; P = 0.02). Using the oximetric angiosome, the percent difference in the areas of oxygen extraction fraction within the 0.7–1.0 range (expected oxygen extraction fraction during exercise) between rest and exercise was higher in healthy subjects (8 ± 4%) than in subjects with diabetes (4 ± 4%; P = 0.02). Conclusion This study demonstrates the feasibility of measuring skeletal muscle oxygen extraction fraction in the foot muscle during a toe-flexion isometric exercise. Instead of assessing oxygen extraction fraction in a foot muscle region linked to a supplying artery (traditional angiosome), the foot oximetric angiosome model assesses oxygen extraction fraction by its different levels in all foot muscle regions and thus may be more appropriate for assessing local ischemia in ulcerated diabetic feet.

Arterial spin labeling magnetic resonance imaging quantifies tissue perfusion around foot ulcers

“…This published method reduces the medial longitudinal angle of the foot and activates the intrinsic muscles of the foot, especially the abductor hallucis muscle. 22 , 23 The exercise was demonstrated, and volunteers were allowed to practice. The volunteer’s foot was once again placed in the foot coil.…”

Feasibility of Multiparametric Perfusion Assessment in Diabetic Foot Ulcer Using Intravoxel Incoherent Motion and Blood Oxygenation‐Level Dependent MRI

“…IVIM and BOLD image volumes of the foot were segmented into five volumes of interest (VOI) corresponding with angiosomes supplied by specific arteries in the foot similar to previous studies 12,18,23 using semiautomated segmentation in MATLAB R2021a (Mathworks, Inc., Natick, MA). The analysis focuses on the medial plantar (MP) and lateral plantar (LP) volumes of interest coinciding with the location of plantar ulcers in the DFU group.…”

Pathogen-specific molecular imaging and molecular testing methods in the prognosis of the complicated course of diabetic foot syndrome, the risk of amputation, and patient survival

“…В работе J. Zheng и соавт. (2016) опубликованы данные о возможностях построения неконтрастных МРТ-перфузионных ангиосомальных карт стоп у здоровых лиц и пациентов с СД [37]. Измерения перфузии стоп проводились во время физической нагрузки.…”

“…Было замечено, что эта новая «ангиосома» больше, чем традиционная ангиосомная модель, подходит для обнаружения ишемических кожных участков, ассоциированных с язвами стопы. Исследования оксигенации тканей у больных СД нашло продолжение в оценке оксиметрии скелетных мышц [37].…”