Sunay Sibel KARAYOL, Mustafa SEVER, Saime SHERMATOVA, Abdurrahim DUSAK

Diyabetik Ayak Komplikasyonlarının Farklı Görüntüleme Yöntemlerinin Kan Akımı Bulguları ile İlişkisinin Karşılaştırılması

Amaç: Bu çalışmanın amacı diyabetik ayak hastalarında farklı görüntüleme yöntemlerine göre yumuşak doku ve kemik lezyonlarının vasküler akım ile ilişkisini belirlemektir.Materyal ve Metod: Bu retrospektif, kesitsel, tanımlayıcı çalışma bir üniversite hastanesinin Radyodiag-nostik bölümünde yapıldı.Bulgular: En sık görülen bulgu selülit (n:57, %72.2) ve en az görülen bulgu subkondral kist (n:14, %17.7) idi. RDUS bulgularına göre %24,1'inde arteriyel kan akımı yoktu, %27,8'inde monofazik idi. 41 (%51,9) hastada RDUS'ta vasküler kan akımı yetersiz olarak kabul edildi. BTA görüntülerinde hastaların %21.5'inde tam tıkanıklık, %20.3'ünde >%70 daralma saptandı. BTA bulgularına göre 46 (%58,2) hastada vasküler kan akımı yetersiz kabul edildi. RDUS bulgularının yorumlanmasında osteomiyelit saptanan hastaların %63'ünde, selülit saptananların %61'inde, apse saptananların %34'ünde, tenosinovit sapta-nanların %34'ünde, eklem efüzyonu saptananların %29'unda ve subkondral kist saptanan hastaların %29'unda yetersiz kan akımı saptandı. Sadece selülit saptanan hastalarda RDUS ile belirlenen kan akı-mında istatistiksel olarak anlamlı fark saptandı (p=0.021).Sonuç: Diyabete bağlı gelişen komplikasyonların tanısında ve ampütasyon kararında hem RDUS hem de BTA görüntüleme yöntemleri değerlidir.

Anahtar Kelimeler:

Renkli Doppler Ultrasonografi, Bilgisayarlı Tomografi Anjiografi, Diyabetik Ayak, Manyetik Rezonans Görüntüleme

A Comparison of the Association of Different Imaging Methods of Diabetic Foot Complications with Blood Flow Findings

Background: The aim of this study was to determine the relationship of soft tissue and bone lesions with vascular flow according to different imaging methods in patients with diabetic foot.Materials and Methods: This retrospective, cross-sectional, descriptive study was conducted in the Radiodiagnostic Department of a university hospital.Results: The most commonly seen finding was cellulitis (n:57, 72.2%) and the least seen was subchond-ral cyst (n:14, 17.7%). According to the CDUS findings, arterial blood flow was absent in 24.1%, and was monophasic in 27.8%. Vascular blood flow on CDUS was accepted as insufficient in 41 (51.9%) patients. On the CTA images, complete obstruction was determined in 21.5% of patients and >70% narrowing in 20.3%. Vascular blood flow was accepted as insufficient in 46 (58.2%) patients according to the CTA findings. In the interpretation of the CDUS findings, insufficient blood flow was determined in 63% of the patients determined with osteomyelitis, in 61% with cellulitis, in 34% with abscess, in 34% with tenosy-novitis, in 29% with joint effusion, and in 17%with subchondral cyst. A statistically significant difference was determined in the blood flow determined with CDUS only in the patients determined with cellulitis (p=0.021). Conclusions: In the diagnosis of complications developing secondary to diabetes, and in the decision for amputation, both CDUS and CTA imaging methods are of value.

Keywords:

Colour Doppler Ultrasonography, Computed Tomography Angiography, Diabetic Foot, Magnetic Resonance Imaging,

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