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Abstract
BackgroundLower extremity atherosclerosis (LEA) is among the most serious diabetic complications and leads to non-traumatic amputations. The recently developed dual-source CT (DSCT) and 320- multidetector computed tomography (MDCT) may help to detect plaques more precisely. The aim of our study was to evaluate the differences in LEA between diabetic and non-diabetic patients using MDCT angiography.MethodsDSCT and 320-MDCT angiographies of the lower extremities were performed in 161 patients (60 diabetic and 101 non-diabetic). The plaque type, distribution, shape and obstructive natures were compared.ResultsCompared with non-diabetic patients, diabetic patients had higher peripheral neuropathy, history of cerebrovasuclar infarction and hypertension rates. A total of 2898 vascular segments were included in the analysis. Plaque and stenosis were detected in 681 segments in 60 diabetic patients (63.1%) and 854 segments in 101 non-diabetic patients (46.9%; p <0.05). Regarding these plaques, diabetic patients had a higher incidence of mixed plaques (34.2% vs. 27.1% for non-diabetic patients). An increased moderate stenosis rate and decreased occlusion rate were observed in diabetic patients relative to non-diabetic patients (35.8% vs. 28.3%; and 6.6% vs. 11.4%; respectively). In diabetic patients, 362 (53.2%) plaques were detected in the distal lower leg segments, whereas in non-diabetic patients, 551 (64.5%) plaques were found in the proximal upper leg segments. The type IV plaque shape, in which the full lumen was involved, was detected more frequently in diabetic patients than in non-diabetic patients (13.1% vs. 8.2%).ConclusionDiabetes is associated with a higher incidence of plaque, increased incidence of mixed plaques, moderate stenosis and localisation primarily in the distal lower leg segments. The advanced and non-invasive MDCT could be used for routine preoperative evaluations of LEA.
Highlights
Lower extremity atherosclerosis (LEA) is among the most serious diabetic complications and leads to non-traumatic amputations
A circular region of interest (ROI) for attenuation measurement was placed in the common iliac artery; data acquisition was initiated as soon as the signal intensity in this ROI reached a threshold of 100 Hounsfield units (HU)
Plaque type and stenosis degree A total of 2898 vascular segments were included in the analysis
Summary
Lower extremity atherosclerosis (LEA) is among the most serious diabetic complications and leads to non-traumatic amputations. The recently developed dual-source CT (DSCT) and 320- multidetector computed tomography (MDCT) may help to detect plaques more precisely. The aim of our study was to evaluate the differences in LEA between diabetic and non-diabetic patients using MDCT angiography. Lower extremity atherosclerosis (LEA) is among the LEA is always insidious, and it is very important to conduct early and accurate imaging evaluations in diabetic patients to improve patient outcomes, reduce the amputation rates and amputation planes and reduce the treatment costs [6]. Regarding the development of imaging technologies, multidetector computed tomography (MDCT) has been widely used for non-invasive vascular imaging evaluations [8,9,10]. The purposes of this study were to explore the application of MDCT angiography for LEA and evaluate the differences in LEA plaque prevalence and morphology between diabetic and non-diabetic patients
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