Evaluation of diabetic foot ulcer healing with hyperspectral imaging of oxyhemoglobin and deoxyhemoglobin.
Evaluation of diabetic foot ulcer healing with hyperspectral imaging of oxyhemoglobin and deoxyhemoglobin.
复制标题
用氧合血红蛋白和脱氧血红蛋白的高光谱成像评估糖尿病足溃疡愈合。
DOI：
10.2337/dc08-2246
复制
发表时间：
2009-11
期刊：
影响因子：
16.2
通讯作者：
Medenilla E
中科院分区：
文献类型：
--
作者：
Nouvong A;Hoogwerf B;Mohler E;Davis B;Tajaddini A;Medenilla E
足部溃疡仍然是糖尿病患者的主要健康问题，并对糖尿病治疗费用产生重大影响。我们测试了一种高光谱成像技术，该技术量化皮肤组织血红蛋白氧合，并生成解剖学相关的组织氧合图，以评估糖尿病足溃疡（DFU）的愈合潜力。完成了一项前瞻性单组盲法研究，其中招募了66例1型和2型糖尿病患者，并随访了24周。收集临床、医疗和糖尿病史。在踝关节处测量经皮氧分压。浅表组织氧合血红蛋白（oxy）和脱氧血红蛋白（deoxy）的测量与高光谱成像从完整的组织接壤的溃疡。使用来自氧和脱氧值的愈合指数评估愈合潜力。54名患者的73处溃疡完成了研究;在24周时，54处溃疡愈合，19处溃疡未愈合。当使用愈合指数预测愈合时，敏感性为80%（43/54），特异性为74%（14/19），阳性预测值为90%（43/48）。去除骨痂测量导致的3例假阳性骨髓炎病例和4例假阴性病例后，灵敏度、特异性和阳性预测值分别增加到86%、88%和96%。结果表明，皮肤组织氧合与糖尿病患者的伤口愈合相关。组织氧和脱氧的高光谱成像可以基于从单次访问获得的信息以高灵敏度和特异性预测DFU的愈合。
Foot ulceration remains a major health problem for diabetic patients and has a major impact on the cost of diabetes treatment. We tested a hyperspectral imaging technology that quantifies cutaneous tissue hemoglobin oxygenation and generated anatomically relevant tissue oxygenation maps to assess the healing potential of diabetic foot ulcers (DFUs). A prospective single-arm blinded study was completed in which 66 patients with type 1 and type 2 diabetes were enrolled and followed over a 24-week period. Clinical, medical, and diabetes histories were collected. Transcutaneous oxygen tension was measured at the ankles. Superficial tissue oxyhemoglobin (oxy) and deoxyhemoglobin (deoxy) were measured with hyperspectral imaging from intact tissue bordering the ulcer. A healing index derived from oxy and deoxy values was used to assess the potential for healing. Fifty-four patients with 73 ulcers completed the study; at 24 weeks, 54 ulcers healed while 19 ulcers did not heal. When using the healing index to predict healing, the sensitivity was 80% (43 of 54), the specificity was 74% (14 of 19), and the positive predictive value was 90% (43 of 48). The sensitivity, specificity, and positive predictive values increased to 86, 88, and 96%, respectively, when removing three false-positive osteomyelitis cases and four false-negative cases due to measurements on a callus. The results indicate that cutaneous tissue oxygenation correlates with wound healing in diabetic patients. Hyperspectral imaging of tissue oxy and deoxy may predict the healing of DFUs with high sensitivity and specificity based on information obtained from a single visit.