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Oximetric angiosome imaging in diabetic feet
Author(s) -
Zheng Jie,
Muccigrosso David,
Zhang Xiaodong,
An Hongyu,
Coggan Andrew R.,
Adil Bashir,
Hildebolt Charles F.,
Vemuri Chandu,
Geraghty Patrick,
Hastings Mary K.,
Mueller Michael J.
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25461
Subject(s) - isometric exercise , medicine , magnetic resonance imaging , calf muscle , skeletal muscle , diabetic foot , foot (prosody) , diabetes mellitus , oxygenation , cardiology , anatomy , nuclear medicine , radiology , endocrinology , linguistics , philosophy
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. J. Magn. Reson. Imaging 2016. J. MAGN. RESON. IMAGING 2016;44:1–1.