Analysis of muscle microcirculation in advanced diabetes mellitus by contrast enhanced ultrasound

Diabetes Research and Clinical Practice
Daniel DuerschmiedChristoph Hehrlein

Abstract

Contrast enhanced ultrasound (CEUS) was recently established to quantify perfusion deficits in peripheral arterial disease (PAD). However, this approach was not suitable to assess microangiopathy of skeletal muscle, a major contributor to PAD in diabetic patients. We hypothesized that an optimized methodology would detect impaired microcirculation. Ten patients with advanced diabetes mellitus (mean diabetes duration 21 years), 10 PAD patients, and 10 control subjects were enrolled consecutively. The arrival times of the contrast agent Sonovue after intravenous injection were assessed selectively in a small artery, muscle tissue and a muscle vein of the calf muscle. Contrast transit times (CTTs) were calculated as the differences between arrival times. The median CTT for artery-vein was significantly higher in the diabetes group (43 s) than in the PAD (22 s, p=0.007) and control groups (11 s, p<0.001, no value overlap). CTTs for artery-muscle and muscle-vein were shorter with highest median values in the diabetes group. We validated improved CEUS as consistent method to detect changes in the microvascular bed. This method may become a valuable tool to quantify impaired microcirculation in diabetes and help to improve patient care.

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Citations

Aug 18, 2009·Ultrasound in Medicine & Biology·Martin KrixMarc-André Weber
Mar 11, 2015·The Journal of Veterinary Medical Science·Juyeon OhJihye Choi
Nov 29, 2008·Radiologic Clinics of North America·Andrea Donovan, Mark E Schweitzer
Oct 1, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Christoph Hehrlein
Sep 17, 2010·Journal of Vascular Surgery·Daniel DuerschmiedChristoph Hehrlein
Jun 20, 2017·Respiratory Physiology & Neurobiology·Hannes KlenzeDavid Johannes Walker
Oct 25, 2017·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Xiao-Xia HouYuan Yu

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