■评估足肌酰胺质子转移加权(APTw)对比剂和组织休息灌注在量化糖尿病足(DF)感染中的作用及其与血液参数的相关性。
■经伦理审查委员会批准,这项研究纳入了40例合并DF的糖尿病(DM)患者和31例无DF或其他下肢动脉疾病的DM患者.所有受试者都接受了MRI检查,其中包括足部矢状位APTw和冠状动脉自旋标记(ASL)成像。确定受影响侧病变与非受影响对侧病变的静止状态下的归一化MTRasym(3.5ppm)和血流量(rBF)的比率。评估了这些变量的组间差异。此外,归一化MTRasym(3.5ppm)之间的关联,rBF,和血液参数[空腹血糖(FBG),糖化血红蛋白含量,C反应蛋白,中性粒细胞百分比,和白细胞计数]进行了探索。使用ROC曲线,归一化MTRasym(3.5ppm)的诊断能力,BF,并评估了血液生化标志物在DM中有或没有DF时的区别。
■在DF组中,病变组MTRasym(3.5ppm)和BF及正常组MTRasym(3.5ppm)均高于对照组(p<0.05)。此外,确定归一化MTRasym(3.5ppm)与血液参数之间的相关性,如C反应蛋白,糖化血红蛋白含量,FBG,中性粒细胞比率,和白细胞(p<0.001)。同时,病变中的BF与血液参数之间的关联,如C反应蛋白,中性粒细胞百分比,和FBG(p<0.01)。在DM患者中,标准化MTRasym(3.5ppm)的AUC为0.986(95%CI,0.918-1.00),敏感性为97.22%,特异性为100%。
■标准化MTRasym(3.5ppm)和病灶内的BF可作为一种更安全、更方便的新指标来评估组织感染,而无需使用造影剂。这可能有助于监测和术前评估患有肾功能不全的DF患者。
UNASSIGNED: To evaluate the role of foot muscle amide proton transfer weighted (APTw) contrast and tissue rest perfusion in quantifying diabetic foot (DF) infection and its correlation with blood parameters.
UNASSIGNED: With approval from an ethical review board, this study included 40 diabetes mellitus (DM) patients with DF and 31 DM patients without DF or other lower extremity arterial disease. All subjects underwent MRI, which included foot sagittal APTw and coronal arterial spin labeling (ASL) imaging. The normalized MTRasym (3.5 ppm) and the ratio of blood flow (rBF) in rest status of the affected side lesions to the non-affected contralateral side were determined. The inter-group differences of these variables were evaluated. Furthermore, the association between normalized MTRasym (3.5 ppm), rBF, and blood parameters [fasting blood glucose (FBG), glycosylated hemoglobin content, C-reactive protein, neutrophil percentage, and white blood cell count] was explored. Using an ROC curve, the diagnostic capacity of normalized MTRasym (3.5 ppm), BF, and blood biochemical markers in differentiating with or without DF in DM was assessed.
UNASSIGNED: In the DF group, MTRasym (3.5 ppm) and BF in lesion and normalized MTRasym (3.5 ppm) were higher than those in the control group (p < 0.05). In addition, correlations were identified between normalized MTRasym (3.5 ppm) and blood parameters, such as C-reactive protein, glycosylated hemoglobin content, FBG, neutrophil ratio, and white blood cell (p < 0.001). Meanwhile, association between BF in lesion and blood parameters, such as C-reactive protein, neutrophil percentage, and FBG (p < 0.01). AUC of normalized MTRasym (3.5 ppm) in identifying with/without DF in patients with DM is 0.986 (95% CI, 0.918-1.00) with the sensitivity of 97.22% and the specificity of 100%.
UNASSIGNED: Normalized MTRasym (3.5 ppm) and the BF in lesion may be treated as a safer and more convenient new indicator to evaluate the tissue infection without using a contrast agent, which may be useful in monitoring and preoperatively assessing DF patients with renal insufficiency.