title: Non-contrast MRI perfusion angiosome in diabetic feet.
abstract: OBJECTIVE
  The purpose of this study is to develop a non-contrast magnetic resonance imaging (MRI) approach to evaluate skeletal muscle perfusion in the diabetic foot based on the concept of angiosomes of the foot.
  
  
  METHODS
  Five healthy volunteers and five participants with diabetes (HbA1c = 7.2 ± 1.8%) without a history of peripheral artery disease were examined. The non-contrast perfusion measurements were performed during a toe flexion challenge. Absolute perfusion maps were created and two regions (medial and lateral) on the maps were segmented based on angiosomes.
  
  
  RESULTS
  Regional difference in the perfusion of foot muscle was readily visualized in the MRI perfusion angiosomes during the challenge. In the participants with diabetes, the perfusion during toe flexion challenge was significantly lower than in healthy volunteers (P < 0.01). The average perfusion for the medial plantar region of the right foot was lower in subjects with diabetes (38 ± 9 ml/min/100 g) than in healthy subjects (93 ± 33 ml/min/100 g).
  
  
  CONCLUSIONS
  Non-contrast MRI perfusion angiosome maps demonstrate the feasibility of determining regional perfusion in foot muscles during toe challenge and may facilitate evaluation of muscle perfusion in diabetic feet.
  
  
  CONCLUSIONS
  • Non-contrast MRI perfusion angiosome maps measure regional perfusion in foot muscles non-invasively. • Foot perfusion response to challenge is reduced in persons with diabetes. • MRI perfusion angiosome maps may help evaluation of regional foot muscle perfusion.
authors.affiliation: Mallinckrodt Institute of Radiology, Cardiovascular Imaging Lab, 510 South Kingshighway Blvd. Campus Box 8225, St. Louis, MO, 63110, USA, zhengj@mir.wustl.edu.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.forename: Mary K
authors.initials: MK
authors.lastname: Hastings
authors.forename: David
authors.initials: D
authors.lastname: Muccigross
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.forename: Fabao
authors.initials: F
authors.lastname: Gao
authors.forename: John
authors.initials: J
authors.lastname: Curci
authors.forename: Charles F
authors.initials: CF
authors.lastname: Hildebolt
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mueller
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003287:Contrast Media; D017719:Diabetic Foot / Q000473:pathology*; D005240:Feasibility Studies; D005528:Foot / Q000098:blood supply*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology; D058729:Peripheral Arterial Disease / Q000473:pathology; D011446:Prospective Studies
chemical_list: D003287:Contrast Media
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