糖尿病足的红外线诊断.pptx

THE INFRARED IMAGING OF THE DIABETIC FOOT; A LITTLE HISTORY Infrared Thermography in Diabetes Mellitus P.I.Branemark, S.E.Fagerberg, L.Langer and Save –Soderbergh, Diabetologia 3, 196716 diabetics, 12 women and 4 man, mean age 28, average disease length 13 years ;The emission over toes and metatarso-phalangeal regions was distinctly decreased and gave a sharp transverse boundary. Little or no reduction of the emission was shown over the dorsum of the foot and tibia. Asymmetric patterns were recorded from the only diabetic with local gangrene.; ;Disturbances in the arterial circulation Detection of areas at high risk for ulceration or re-ulceration Assessment of tissues viability, amputation level, and the intra-operative skin flap viability Diagnosis of osteomyelitis Evaluation of the medical treatment effectiveness Assessment of microangiopathy and others vascular changes caused by the neuropathy ;The examination of the diabetic foot;The images are taken at fixed camera/object distances from the both legs in the anterior view, the foot from a top view and the soles Hot spot is defined as an area at least 0,5 C warmer than surroundings The thermal gradient represents the difference between the skin temperature at the knee and at the dorsum of the foot. Thermal imaging of skin changes on the feet of type II diabetics – K.Ammer, P. Melnizky, O.Rathkolb, E.F. Ring- 2001 – 23rd Annual EMBS International Conference ;Changes in the arterial circulation;The “macro-circulation” pathology localizes more often below the popliteal fossa, than at the level of the aorta or iliac vessels The injuries respect the distal (pedal) arteries The changes are usually asymmetric, the tibial – peroneal triangle being the most commonly affected.; Thermography is especially useful to differentiate between “ischemic foot”(cold) and the “neuropathic foot(warm). Detecting areas of critical ischemia;;;ARTERYOGRAPHY; Neuropathic ( 40%) Neuro-ischemic Ischemic ( 10%) ;;;It was