Use of dynamic contrast-enhanced magnetic resonance imaging to evaluate the microcirculation of lower extremity muscles in patients with Type 2 diabetes.

ABSTRACT

AIMS: To quantify the capillary permeability of the lower extremity muscles using dynamic contrast-enhanced magnetic resonance imaging in healthy control subjects without diabetes and patients with diabetes before and after percutaneous angioplasty. METHODS: Fifty-five patients (30 without diabetes, 25 with Type 2 diabetes with occluded vasculature of the lower extremities) were examined by dynamic contrast-enhanced magnetic resonance imaging. The transfer constant (K-trans) of the tibialis anterior muscle was determined before (for all patients) and after (for patients with diabetes only) percutaneous angioplasty of the intrapopliteal artery. Clinical assessment was also recorded. Statistical significant differences were defined at the level of P < 0.05. RESULTS: Before percutaneous angioplasty, patients with diabetes displayed significantly lower K-trans values in the tibialis anterior muscles than control subjects. Although percutaneous angioplasty increased the K-trans of these patients, the final values were still less than those of the control group. Differences were also observed between the groups in the Fontaine classification and ankle-brachial index, which reflect ischaemia in the lower extremities. After percutaneous angioplasty, these values were increased in the group with diabetes. CONCLUSION: K-trans can be used to quantify changes in the capillary permeability of the lower extremity muscles, reflecting the microcirculation of the lower extremities.