糖尿病足的红外线诊断幻灯片教程.ppt

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 “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.;;;ARTERYOGRAPHY;; Neuropathic ( 40%) Neuro-ischemic Ischemic ( 10%) ;;;It was suggested that examining thermographic patterns, patients with diabetis could be screened for risk of ulceration and that high temperature were predictive of ulceration. In patients with diabetes peripheral neuropathies, and no additional pathology, the temperature of the right and the left lower extremities were not different.;Infrared dermal thermometry for the High-Risk diabetic foot D.Armstrong, L.Lavery, P.Liswood, W.Todd, J.Tredweell-Physical Therapy, 77, 2, february 1997 All patients who experienced ulceration or re - ulceration during the follow-up period showed elevated skin temperature gradients. ;The patients can be monitored to prevent ulcerations, higher temperatures having a predictive