2型糖尿病患者的足部磁共振体素内不相干运动参数和足底压力分析38例

Analysis of Incoherent Motion Parameters and Plantar Pressure in 38 Cases of Foot Magnetic Resonance Voxel in Patients with Type 2 Diabetes Mellitus

目的探讨2型糖尿病患者足部肌群的磁共振体素内不相干运动成像(IVIM)定量数据、足底压力数据特点以及其用于诊断糖尿病足的价值。方法选取2019年3月—2021年3月38例2型糖尿病患者,分为16例糖尿病足组(DF)和22例非糖尿病足组(NDF),记录每例受试者的足底压力定量数据(双足前足压力、中足压力、后足压力等),并于足底检查当日完成磁共振IVIM扫描,测量足底内侧肌群的IVIM灌注参数(D值、D^(*)值、f值)。结果两组患者中足、后足压力等及IVIM的f值,差异有统计学意义(P<0.05),前足压力、D值、D^(*)值对比,差异无统计学意义(P>0.05)。将组间差异有统计学意义的参数作为协变量加入Logistics回归模型,以是否发生糖尿病足为因变量,得出f值<0.25是糖尿病足发病的独立危险因素(β=2.359,OR=10.585,P=0.026)。结论糖尿病足患者的足底压力高于非糖尿病足患者,在中足、后足尤为明显;以中足肌群为扫描对象的IVIM参数中,f值低可作为糖尿病足发病的独立危险因素。

Objective To investigate the quantitative data of magnetic resonance intravoxel incoherent motion imaging(IVIM)and plantar pressure data of foot muscles in patients with type 2 diabetes mellitus and its value in the diagnosis of diabetic foot.Methods Thirty-eight patients with type 2 diabetes from March 2019 to March 2021 were selected and divided into 16 cases diabetic foot group(DF)and 22cases non-diabetic foot group(NDF).Quantitative data on plantar pressure(forefoot pressure,midfoot pressure,hindfoot pressure,etc.)were recorded for each subject.Magnetic resonance IVIM scan was completed on the day of the plantar examination,and the IVIM perfusion parameters(D value,D^(*)value,f value)of the medial plantar muscles were measured.Results There were statistically significant differences in the midfoot and hindfoot pressures and the f value(Avg)of IVIM between the two groups(P<0.05).There was no statistically significant difference in forefoot pressure,D value and D^(*)value(P>0.05).The parameters with the differences was statistically significant between groups,and f value,were added to the Logistic regression model as covariates,with the occurrence of diabetic foot as the dependent variable.It was concluded that f value<0.25 was an independent risk factor for diabetic foot disease(β=2.359,OR=10.585,P=0.026).Conclusion The plantar pressure of diabetic foot patients is higher than that of non-diabetic foot patients,especially in the midfoot and hindfoot.Among the IVIM parameters scanning the midfoot muscle group,low f value can be used as an independent risk factor for the incidence of diabetic foot.