Ye Song1, Yuan Li1, Pei-Jun Wang2, Yuan Gao3. 1. Department of Ultrasound Diagnosis, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China. 2. Department of Radiology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China. 3. Department of General Surgery, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
Abstract
PURPOSE: To explore the applicability of contrast-enhanced ultrasound (CEUS) as a new method to detect impaired microcirculation in type 2 diabetes mellitus patients with microvascular complications (DM+MC). METHODS: Ultrasound contrast agent was injected into peripheral vein of 28 patients with DM+MC, 30 uncomplicated type 2 diabetes mellitus (DM) patients, and 30 control subjects. Its appearance in the calf muscle was detected by contrast-enhanced ultrasound. Time-intensity curves were established based on mathematical modeling, particularly in small artery, muscular tissue and small vein. Times to peak intensity (TTPs), arrival times (ATs) and contrast transit times (CTTs) were analyzed. CTTs were calculated as the differences between arrival times. With patients under fasting conditions, plasma glucose and rheologic parameters of erythrocyte deformability and plasma viscosity were measured. RESULTS: DM and DM+MC groups tended to have longer TTPs than the control group, but without significant differences between DM group and DM+MC group. The median artery-vein and muscle-vein CTTs were statistically significantly highest in the DM+MC group (P < 0.05). Blood viscosity in the DM+MC group was higher than two other groups (P < 0.05). Blood viscosity correlated positively with both blood glucose and C-reactive peptide (P < 0.01). CONCLUSION: CEUS is potentially reliable to detect changes in the microvascular bed. Abnormalities in capillary recruitment may be related to abnormal hemorheology.
PURPOSE: To explore the applicability of contrast-enhanced ultrasound (CEUS) as a new method to detect impaired microcirculation in type 2 diabetes mellituspatients with microvascular complications (DM+MC). METHODS: Ultrasound contrast agent was injected into peripheral vein of 28 patients with DM+MC, 30 uncomplicated type 2 diabetes mellitus (DM) patients, and 30 control subjects. Its appearance in the calf muscle was detected by contrast-enhanced ultrasound. Time-intensity curves were established based on mathematical modeling, particularly in small artery, muscular tissue and small vein. Times to peak intensity (TTPs), arrival times (ATs) and contrast transit times (CTTs) were analyzed. CTTs were calculated as the differences between arrival times. With patients under fasting conditions, plasma glucose and rheologic parameters of erythrocyte deformability and plasma viscosity were measured. RESULTS:DM and DM+MC groups tended to have longer TTPs than the control group, but without significant differences between DM group and DM+MC group. The median artery-vein and muscle-vein CTTs were statistically significantly highest in the DM+MC group (P < 0.05). Blood viscosity in the DM+MC group was higher than two other groups (P < 0.05). Blood viscosity correlated positively with both blood glucose and C-reactive peptide (P < 0.01). CONCLUSION: CEUS is potentially reliable to detect changes in the microvascular bed. Abnormalities in capillary recruitment may be related to abnormal hemorheology.
Entities:
Keywords:
Contrast-enhanced ultrasound; microcirculation; microvascular complications; type 2 diabetes mellitus
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