Evaluation of Skeletal Muscle Microcirculation and Reserve Function of the Type 2 Diabetes with Contrast-Enhanced Ultrasonography

Xu, Zhenhong; Chen, Jiaohong; Huang, Fengbin; Lv, Guorong

doi:10.1097/ruq.0000000000000459

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…[ 14 ] This was later echoed by Xu et al .’s finding that patients with DM and MC have a significantly prolonged arrival time difference of contrast agent in the arteries, muscles and veins, implying a lower arterial blood reserve compared to those without MC. [ 15 ] Irace et al . induced temporary ischemia in the forearm of type-1 DM patients without known vascular complications.…”

Section: R Esults and Discussionsmentioning

confidence: 99%

Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives – A Review

Hsiao

Chen

Wang

et al. 2023

Journal of Medical Ultrasound

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Contrast-enhanced ultrasound (CEUS) uses an intravascular contrast agent to enhance blood flow signals and assess microcirculation in different parts of the human body. Over the past decade, CEUS has become more widely applied in musculoskeletal (MSK) medicine, and the current review aims to systematically summarize current research on the application of CEUS in the MSK field, focusing on 67 articles published between January 2001 and June 2021 in online databases including PubMed, Scopus, and Embase. CEUS has been widely used for the clinical assessment of muscle microcirculation, tendinopathy, fracture nonunions, sports-related injuries, arthritis, peripheral nerves, and tumors, and can serve as an objective and quantitative evaluation tool for prognosis and outcome prediction. Optimal CEUS parameters and diagnostic cut off values for each disease category remain to be confirmed.

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Section: R Esults and Discussionsmentioning

confidence: 99%

Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives – A Review

Hsiao

Chen

Wang

et al. 2023

Journal of Medical Ultrasound

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“…9 Impaired perfusion in lower extremities has also been observed in patients with DM, with and without foot complications, by utilizing several image modalities. [10][11][12][13][14][15] Insufficient tissue perfusion may be a critical factor limiting muscle…”

Section: Introductionmentioning

confidence: 99%

“… 9 Impaired perfusion in lower extremities has also been observed in patients with DM, with and without foot complications, by utilizing several image modalities. 10 – 15 Insufficient tissue perfusion may be a critical factor limiting muscle hypertrophy and regeneration in response to exercise and injury stimulus and over all muscle performance.…”

Section: Introductionmentioning

confidence: 99%

Deteriorated regional calf microcirculation measured by contrast-free MRI in patients with diabetes mellitus and relation with physical activity

Zheng

Sorensen

et al. 2021

Diabetes and Vascular Disease Research

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Objective: To evaluate regional calf muscle microcirculation in people with diabetes mellitus (DM) with and without foot ulcers, compared to healthy control people without DM, using contrast-free magnetic resonance imaging methods. Methods: Three groups of subjects were recruited: non-DM controls, DM, and DM with foot ulcers (DM + ulcer), all with ankle brachial index (ABI) > 0.9. Skeletal muscle blood flow (SMBF) and oxygen extraction fraction (SMOEF) in calf muscle were measured at rest and during a 5-min isometric ankle plantarflexion exercise. Subjects completed the Yale physical activity survey. Results: The exercise SMBF (ml/min/100 g) of the medial gastrocnemius muscle were progressively impaired: 63.7 ± 18.9 for controls, 42.9 ± 6.7 for DM, and 36.2 ± 6.2 for DM + ulcer, p < 0.001. Corresponding exercise SMOEF was the lowest in DM + ulcers (0.48 ± 0.09). Exercise SMBF in the soleus muscle was correlated moderately with the Yale physical activity survey ( r = 0.39, p < 0.01). Conclusions: Contrast-free MR imaging identified progressively impaired regional microcirculation in medial gastrocnemius muscles of people with DM with and without foot ulcers. Exercise SMBF in the medial gastrocnemius muscle was the most sensitive index and was associated with HbA1c. Lower exercise SMBF in the soleus muscle was associated with lower Yale score.

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The value of contrast-enhanced ultrasound in the diagnosis of microcirculatory perfusion abnormalities in diabetic foot

He,

Yan,

Yuan

et al. 2024

Int J Diabetes Dev Ctries

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Background Diabetic foot is one of the most serious complications of type 2 diabetes mellitus (T2DM), and its incidence is increasing in China. Early detection of abnormal microcirculation in the foot is very important for the prevention and treatment of diabetic foot. Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in diagnosing microcirculatory alterations in the dorsum of the foot for patients with type 2 diabetes mellitus (T2DM). Methods Eighty-eight T2DM patients were included, among them 30 patients sustained diabetes mellitus without complications (group A), 28 with lesions in the dorsum of the foot (no acute infection) that can be classified as Wagner grade 0 ~ 1 (group B), and 30 with lesions in the dorsum of the foot that can be classified as Wagner grade 2–5 (group C). Another 30 healthy adults were included as the control group. All subjects underwent CEUS to examine the dorsalis pedis arteries and blood perfusion to the underlying soft tissues. Parameters of the time-intensity curve (TIC), including rise time (RT), ascending slope (AS), time to peak (TTP), peak intensity (PI), area under the curve (AUC), and half of drop time (DT/2) were analyzed. Results The analysis of TIC data of the dorsalis pedis arteries showed that group C had decreased AS, PI, and AUC and increased TTP, RT, and DT/2 compared with groups A, B, and the control group; the differences were statistically significant (p < 0.05). The analysis of TIC data of the perfusion to the underlying soft tissues showed that AS, PI, and AUC decreased from the control group through group A, B, and then C; the differences were all statistically significant (p < 0.05). The TIC data were correlated with the severity of microcirculatory impairment in the dorsum of the foot and among them the AUC, PI, and AS had higher predictive value. Conclusions Microcirculatory impairment in the dorsum of the foot in T2DM patients presents itself as “delayed wash-in, delayed wash-out, and weak enhancement” on CEUS images. CEUS can provide quantification of the microcirculatory changes in the soft tissues in the dorsum of the foot and reflect the differences of microcirculatory perfusion across different grades of lesions.

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Evaluation of Skeletal Muscle Microcirculation and Reserve Function of the Type 2 Diabetes with Contrast-Enhanced Ultrasonography

Cited by 3 publications

References 8 publications

Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives – A Review

Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives – A Review

Deteriorated regional calf microcirculation measured by contrast-free MRI in patients with diabetes mellitus and relation with physical activity

The value of contrast-enhanced ultrasound in the diagnosis of microcirculatory perfusion abnormalities in diabetic foot

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