Microcirculatory function in diabetic foot muscles with MRI

MRI 观察糖尿病足部肌肉的微循环功能

• 批准号: 9222753
• 负责人: MARY K HASTINGS
• 金额: $ 55.58万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9222753
• 关键词: Address; Amputation; Ankle; Arteries; Attenuated; Biological Preservation; Blood Vessels; Blood flow; Calcified; Clinical; Complications of Diabetes Mellitus; Development; Diabetes Mellitus; Diabetic Foot; Diabetic Foot Ulcer; Distal; Evaluation; Exercise; Foot Ulcer; Foundations; Goals; Image; Imaging Techniques; Impaired wound healing; Impairment; Intervention; Investigation; Ischemia; Leg; Limb structure; Lower Extremity; Magnetic Resonance Imaging; Measurement; Measures; Microcirculation; Microcirculatory Bed; Muscle; Operative Surgical Procedures; Outcome; Outcomes Research; Oxygen; Patients; Perfusion; Peripheral Nervous System Diseases; Peripheral Vascular Diseases; Probability; Recruitment Activity; Regional Blood Flow; Regional Perfusion; Rest; Risk; Role; Schedule; Severities; Skeletal Muscle; Techniques; Testing; Tissues; Toes; Translating; Ulcer; Ursidae Family; Veins; Wound Healing; attenuation; base; calcification; clinical practice; foot; healing; improved; indexing; novel; outcome forecast; pressure; public health relevance; volunteer; wound

 DESCRIPTION (provided by applicant): Foot ulcers are an important complication of diabetes mellitus and often precede lower- extremity amputation. Insufficient perfusion, due to peripheral vascular disease and/or diabetes, of the tissues may be the most important component contributing to ulcer formation and limiting healing. However, it is historically very difficult to assess distal leg and foot perfusion accurately. We recently demonstrated a novel, non-contrast, magnetic resonance imaging (MRI)-based approach to quantify skeletal muscle microcirculation, specifically skeletal muscle blood flow and oxygen extraction fraction distributions. The objective of this study is to translate these techniques to characterize the skeletal muscle microcirculation in calf and foot muscles in groups of patients with diabetes, with and without ulcers. The long term goal is to promote microcirculation as a prime evaluation target before embarking on interventional treatment for limb preservation in patients with diabetes. Two specific aims will be addressed. Specific Aim 1 will determine the relationships between regional blood flow, oxygen extraction fraction, and the presence of pedal ulcers in patients with diabetes, with and without peripheral vascular disease. Specific Aim 2 will determine how pre-surgical and post-surgical measures of skeletal muscle blood flow and oxygen extraction fraction are related to wound healing following vascular surgery in patients with DM who also have peripheral vascular disease. All study will be performed at rest and during a controlled exercise. It is hypothesized that increases in skeletal muscle blood flow and oxygen extraction fraction in plantar muscles during exercise is substantially attenuated in patients with diabetes, peripheral vascular disease, and a plantar foot ulcer. And this attenuation is inversely correlated with foot ulcer healing in patients' post-revascularization. The completion of this study will provide a foundation for further detailed understanding of role of the local wound perfusion, which is essential to developing a management plan and establishing prognosis for patients with a foot ulcer.

 描述（由申请人提供）：足部溃疡是糖尿病的重要并发症，通常发生在下肢截肢之前。由于外周血管疾病和/或糖尿病导致的组织灌注不足可能是导致溃疡形成和限制愈合的最重要因素。然而，从历史上看， 准确评估远端腿部和足部灌注。我们最近展示了一种新的，非对比，磁共振成像（MRI）为基础的方法来量化骨骼肌微循环，特别是骨骼肌血流量和氧提取分数分布。本研究的目的是将这些技术转化为糖尿病患者组小腿和足部肌肉骨骼肌微循环的特征， 而且没有溃疡长期目标是在糖尿病患者进行保肢介入治疗之前，将促进微循环作为首要评价指标。 将讨论两个具体目标。具体目标1将确定糖尿病患者（伴或不伴外周血管疾病）局部血流量、氧摄取分数和足部溃疡之间的关系。具体目标2将确定术前和术后骨骼肌血流量和氧摄取分数的测量值如何与同时患有外周血管疾病的DM患者血管手术后的伤口愈合相关。所有研究将在休息和受控运动期间进行。据推测，在糖尿病、外周血管疾病和足底溃疡患者中，运动期间足底肌肉中骨骼肌血流量和氧提取分数的增加显著减弱。这种衰减 与患者血运重建后足部溃疡愈合呈负相关。完成 本研究的结果将为进一步详细了解局部伤口灌注的作用提供基础，这对于制定治疗计划和确定足部溃疡患者的预后至关重要。