Characterization of Microcirculatory Function in Diabetic Leg and Foot with MRI

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。溃疡周围组织灌注不足可能是溃疡形成和愈合的最大限制因素。然而，历史上很难准确评估远端腿部和足部灌注。本研究的目的是评价一种新开发的非增强MRI技术，以表征小腿和足部局部骨骼肌微循环。这将在糖尿病和足部溃疡患者组中进行，并与健康受试者和外周血管疾病患者进行比较。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目标。 将讨论两个具体目标。具体目标1将比较非造影MRI骨骼肌灌注和氧合技术与临床方法，以评估下肢灌注。具体目标2将确定局部骨骼肌灌注/氧合与糖尿病患者足部溃疡之间的关系。这将与周围血管疾病和足部溃疡患者以及健康志愿者进行比较。所有研究将在休息时和激发运动期间进行。据推测，这些区域灌注和氧合指数将与糖尿病的严重程度和足部溃疡的存在密切相关。这项研究的完成将提供 进一步详细了解局部伤口灌注的基础，这对于制定管理计划和建立预后至关重要。

DESCRIPTION (provided by applicant): Foot ulcers are an important complication of diabetes mellitus and often precede lower- extremity amputation. Insufficient perfusion of the tissues around ulcers may be the most limiting component to ulcer formation and healing. However, it is historically very difficult to assess distal leg and foot perfusion accurately. The objective of ths study is to evaluate a newly developed non-contrast MRI technique to characterize local skeletal muscle microcirculation in calf and foot. This will be performed in groups of patients with diabetes and foot ulcers, in comparison with healthy subjects and patients with peripheral vascular disease. The long term goal is to promote microcirculation as a prime evaluation target before embarking on interventional treatment for limb preservation in a patient with diabetes. Two specific aims will be addressed. Specific Aim 1 will compare the non-contrast MRI skeletal muscle perfusion and oxygenation techniques with clinical methods to assess perfusion of lower extremities. Specific Aim 2 will determine the relationships between regional skeletal muscle perfusion / oxygenation, and the presence of pedal ulcers in patients with diabetes. This will be compared with patients with peripheral vascular disease and foot ulcers, as well as with healthy volunteers. All study will be performed at rest and during a challenge exercise. It is hypothesized that these regional perfusion and oxygenation indices will be strongly associated with the severity of diabetes and presence of foot ulcer. The completion of this study will provide a foundation for further detailed understanding of the local wound perfusion, which is essential to developing a management plan and establishing prognosis.