CT-Angiography of the lower extremities and CT-perfusion of the feet in the diagnosis, planning and tracking of the result of revascularization in a patient with diabetic foot syndrome

Abstract

Purpose. To study the diagnostic possibilities of feet CT-perfusion in patients with diabetic foot syndrome before and after revascularization. Materials and methods. The examination of patient K., 55 years old, are given. From patient's history it is known, that he suffers from diabetes mellitus type II type more 10 years, 6 years ago patient have undergone surgical resection of let foot phlegmon near the basic of the first finger. Subsequently, a granulating wound and a fistula with purulent discharge formed in this area, which have persisted to the present time. He was self-treated symptomatically. During last six months, he noticed pain when walking (200 m) in the left tibia. Multislice computed angiography, multislice computed perfusion of the feet, angiography before and after revascularization were performed. Results. The results of feet CT-perfusion before the revascularization allowed us to determine the area of hyperperfusion in the form of a belt, at the base of the first finger and the inner side surface of ulcerous-necrotic lesions; after revascularization it allowed us to determine the area of hyperperfusion in postoperative changes, which may correspond to the active reparative processes. The results of CT-angiography allowed to determine the nature of the lesion severity and the variant of anatomical development of the arteries of the lower extremities. Conclusion. The obtained results of CT-perfusion indicate the effectiveness of determining the zone of ischemia of the lower limb, as well as tracking the dynamics of blood supply to the foot tissues after revascularization. The results of CT-angiography allowed de-termining the strategy and tactics of revascularization.