Capabilities of Contrast Magnetic Resonance Angiography in the Diagnosis of Diabetic Foot Complicated by Purulent Necrotic Processes

Purpose: evaluation of pedal vascularisation in diabetic patients with pedal purulent necrotic processes of using contrast MR-angiography (3D DCE-MRA). Material and methods. 31 diabetic foot of 31 patients (14 male, 17 female; mean age 54.65 ± 15.1) underwent 3d DCE-MRA (Gadobutrol 15 ml) at 1.5 T. Imaging analysis included vascular architectonic’s condition, blood-flow’s speed and character of contrast’s accumulation. Results were compared with white blood cells-scan in identification of pyoinflamation. Osteomyelitis was verified according to operations in 100% cases. Results. All patients were divided in 3 groups: neuropathic (n = 12; 38.7%), neuroischemic (n = 14; 45.2%), ischemic (n = 5; 16.1%) forms of diabetic foot. First-pass MRA detected significantly delay in contrast’s arrival in ischemic group. There were no significant differences between the values of neuropathic and neuroischemic forms of diabetic foot. There was absence of any pedal vessels in patients. Contrast MR-angiography revealed the three types of contrast distribution in soft tissues: uniform, local increase and local absence. Osteomyelitis associated with diffuse enhanced contrast accumulation in all cases. Conclusion. So MRI blood vessel imaging is a promising and valuable method for examining peripheral arterial changes in diabetic foot and may be useful for treatment planning in different forms of diabetic foot.

синдром диабетической стопы, сосуды стопы, контрастная магнитно-резонансная ангиография, остеомиелит, diabetic foot, pedal vessels, contrast MR-angiography, osteomyelitis

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