课件：糖尿病足的红外线诊断.pptx

THE INFRARED IMAGINGOF THE DIABETIC FOOTZhi-jie Xi, M.D.Department of OrthopaedicsShanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine A LITTLE HISTORYInfrared Thermography in Diabetes MellitusP.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 yearsThe 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 circulationDetection of areas at high risk for ulceration or re-ulcerationAssessment of tissues viability, amputation level, and the intra-operative skin flap viabilityDiagnosis of osteomyelitisEvaluation of the medical treatment effectivenessAssessment of microangiopathy and others vascular changes caused by the neuropathyThe examination of the diabetic footRoom temperature : 24 CAcclimatization time: 20 minutesUndressed legsPosition : Orthostatism or seated with the lowers extremities hanging freelyThe images are taken at fixed camera/object distances from the both legs in the anterior view, the foot from a top view and the solesHot spot is defined as an area at least 0,5 C warmer than surroundingsThe 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 ConferenceChanges in the arterial circulationEco-DopplerAngiographyThermographyThe “macro-circulation” pathology localizes more often below the popliteal fossa, than at the level of the aorta or iliac vesselsThe injuries respect the distal (pedal) arteriesThe changes are usually asymmetric, the tibial – peroneal triangle b