Usefulness of Enhanced Power Doppler Imaging in Monitoring Acral Microcirculation in Type 2 Diabetes Mellitus and its Complications

Ma, Fang; Zhao, Bin; Zhang, Huiping; Li, Weiping; Liu, Yuanyuan; Dang, Yuanyuan; Wu, Rong; Guo, Le Hang; Chen, Lu

doi:10.1007/s12013-011-9208-2

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…Similar hemodynamic alterations in the arterioles of the finger and toe in patients with DM were observed by Ma et al [ 27 ] using an e-flow Doppler technique, which was developed from the power Doppler sonographic method. Although blood flow in the acral finger arterioles could be shown by the e-flow Doppler technique, the flow hemodynamic parameters (PSV and EDV) measured by the e-flow Doppler technique were collected in a conventional manner with only one sampling line or sampling point.…”

Section: Discussionsupporting

confidence: 74%

Blood Flow of the Acral Finger Arterioles in Patients With Type 2 Diabetes by Quality Doppler Profiles

Zhang¹,

Xia

Bian

et al. 2013

Cell Biochem Biophys

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Patients with diabetes mellitus exhibit peripheral arterioles lesions that is associated with reduced blood flow. Here, we intended to assess the acral arterioles lesion in patients with type 2 diabetes based on the rate of blood flow by multigate spectral Doppler ultrasonography. Fifty-two patients with type 2 DM were divided into two groups. Group 1 included 13 men and 12 women with an average age of 60.60 ± 14.03 years and a duration of type 2 diabetes for 2.44 ± 1.50 years. Group 2 included 17 men and 11 women with an average age of 64.25 ± 10.84 years and type 2 diabetes for 12.57 ± 6.26 years. Age-matched control subjects (n = 52) were recruited (30 men and 22 woman, mean age of 61.19 ± 10.38 years). A multigate spectral Doppler algorithm was applied to the acral finger of the thumb of the right hand to test the arteriole diameter and hemodynamic parameters, including diameter of the acral finger arterioles (D), area of the blood flow profile of the acral finger arterioles (Amax) and hemodynamic parameters. Patients with diabetes exhibited a significant reduction in the arteriole diameter (1.63 ± 0.18 and 1.57 ± 0.22 mm, respectively, P < 0.001 for both) compared to control subjects (2.09 ± 0.17 mm). Amax were significantly reduced in patients with diabetes (61.35 ± 10.66 mm2/s for group 1 and 46.50 ± 6.59 mm2/s for group 2, P < 0.001 for both) compared to that in control subjects (77.93 ± 12.37 mm2/s). Furthermore, a significant difference in Amax was found between group 1 and group 2 (P < 0.001). The vascular resistance index (RI) was significantly higher in both patient groups 0.58 ± 0.06 for group 1 (P < 0.001) and 0.64 ± 0.07 for group 2 (P < 0.001) than that in control subjects (0.48 ± 0.04). The RI value of the acral finger arterioles differed significantly between group 1 and group 2 (P < 0.01). Diabetic patients exhibited a weak blood flow in the acral finger arterioles. The multigate spectral Doppler technology can be used to test blood flow in the acral finger arterioles and provide hemodynamic data for systematic analyses of the peripheral arteriole lesions in diabetes.

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Section: Discussionsupporting

confidence: 74%

Blood Flow of the Acral Finger Arterioles in Patients With Type 2 Diabetes by Quality Doppler Profiles

Zhang¹,

Xia

Bian

et al. 2013

Cell Biochem Biophys

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“…The mean age and ankle-brachial indexes are 56. 13 The blood vessel diameter and arterial thickness were significantly larger in the diabetes group as compared to the control group (Table 2, Figure 5). There were no significant differences in color Doppler lumen diameters between cases and controls ( The PI of both DPA and RI of right DPA increased in diabetic patients compared to the controls without significant difference (p>0.05) and so the RI in the left PTA (Table 2).…”

Section: Resultsmentioning

confidence: 90%

“…This might be attributed to chronic hyperglycemia, a predisposing risk factor to diabetes-related angiopathies [12]. The increase in flow resistance might also suggest changes in blood vessel walls (wall stiffening), which affects Doppler flow parameters [13].…”

Section: Discussionmentioning

confidence: 99%

A Triplex Ultrasound Evaluation of Preclinical Changes in Type 2 Diabetes in Foot Arteries

Ali¹,

Suliman²,

Abdelrahim³

et al. 2022

Cureus

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Background and objective: Type 2 diabetes mellitus (T2DM) is a significant health problem that is becoming more prevalent worldwide. This study aimed to assess hemodynamic and morphological parameters in diabetic patients' foot arteries and compare them to those obtained in asymptomatic control group.Materials and methods: This is a cross-sectional case-control study. B-mode ultrasound, color Doppler, and pulse wave Doppler were conducted to assess the dorsalis pedis arteries (DPAs) and posterior tibial arteries (PTAs). The morphological, total vascular diameter, wall thickness, and flow Doppler indices were measured. A total of 200 hundred participants were selected randomly using a random sampling technique. One hundred diabetic patients and 100 non-diabetic persons were determined.Results: In diabetic patients, the overall grayscale diameter and wall thickness of foot arteries were statistically significantly larger than the asymptomatic group in the right DPA (p<0.01), left DPA (p<0.001), right PTA (p<0.001), and left PTA (p<0.001). In the diabetic group, the level of hemoglobin A1c (HbA1c) was positively correlated with blood flow resistive index (RI) in the right DPA (r=0.839; p<0.001), left DPA (r=0.801; p<0.001), right PTA (r=0.801; p<0.001), and left PTA (r=0.801; p<0.001). No significant differences were noted in both groups in blood flow Doppler parameters -pulsatility index (PI) and resistive index (RI).Conclusion: Overall grayscale diameters of foot arteries are larger in the diabetes group than in the control group, indicating arterial wall thickening as an early indicator of diabetes-related alterations. PI of both DPA and RI of right DPA were increased in diabetic patients more than the control group. The level of glycosylated hemoglobin A1c (HbA1c) was strongly linked with the blood flow resistive index in diabetes patients.

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“…Doppler flow parameters were also not sensitive indicators of changes in the natural history of diabetes in early periods. 26 Ma et al 27 adopted enhanced power Doppler imaging (e-Flow) to display the acral arterioles (pulps and nail beds of fingers and toes) and the microcirculatory status. They found that although e-Flow was superior to the conventional ultrasound in improving the sensitivity of blood flow signals, there was uncertainty in the display of microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Microcirculation in the Type 2 Diabetic and Impaired Glucose Tolerance Feet of Elderly Men by CEUS

Li¹,

Wu²,

Yang³

et al. 2021

DMSO

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Objective To evaluate the foot microcirculation in type 2 diabetes mellitus (T2DM) and impaired glucose tolerance patients (IGT) with contrast-enhanced ultrasound (CEUS). Methods The study included 37 patients with T2DM but without diabetic foot (DM group), 15 patients with impaired glucose tolerance (IGT group) and 10 elderly males with normal fasting blood glucose (FBS) and negative glucose tolerance tests (control group). Color Doppler flow imaging (CDFI) and CEUS were performed on the right foot great toes for detecting the blood perfusion performance. CEUS images were recorded and parameters of CDFI and flow time-intensity curves (TICs) were analyzed by the Student’s t -test. Results There was no significant difference in CDFI parameters pulse index and peak systolic blood flow velocity (PSV) among the three groups (P >0.05). Compared with control group, CEUS images of IGT and DM groups showed lower microvascular density and were pale. Peak intensity (PI) and area under time-intensity curve (AUC) in control, IGT and DM groups were decreased gradually (PI 46.36±10.96 vs 35.26±11.65 vs 28.15±7.94, P = 0.001, AUC 5.12±1.02 vs 3.25±1.60 vs 2.81±1.20, P = 0.001). The arrival times (AT) and time to peak (TTP) tended to be increased with the extension of DM course, but the difference was not statistically significant (AT, P = 0.260, TTP, P = 0.481). Conclusion CEUS, as a noninvasive and valuable technique, could detect the alterations in foot microcirculation of DM and IGT patients.

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Usefulness of Enhanced Power Doppler Imaging in Monitoring Acral Microcirculation in Type 2 Diabetes Mellitus and its Complications

Cited by 5 publications

References 14 publications

Blood Flow of the Acral Finger Arterioles in Patients With Type 2 Diabetes by Quality Doppler Profiles

Blood Flow of the Acral Finger Arterioles in Patients With Type 2 Diabetes by Quality Doppler Profiles

A Triplex Ultrasound Evaluation of Preclinical Changes in Type 2 Diabetes in Foot Arteries

Assessment of Microcirculation in the Type 2 Diabetic and Impaired Glucose Tolerance Feet of Elderly Men by CEUS

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