Radiological and pathohistological methods of estimation of peripheral segment of the arterial bed for objectivization of the diabetic foot syndrome
Objective. Enhancing of informativity of multidetector computed-tomographic angiography (MDCTA) and histomorphometry of the lower extremities (LE) vessels, using their comparison and determination of clinical validity, including the patients, suffering a diabetic foot syndrome (DFS).
Materials and methods. There were examined 80 patients (all are men) with DFS, to whom preoperative MDCTA of LE and histomorphometry of vascular structures of postoperative biomaterial were done.
Results. MDCTA have had lower sensitivity (31.3%) vs histological investigation, concerning determination of the atherosclerotic pluck kind as well as in accordance to data about a certain known stage of the beginning or maturing of this named pathomorphological process. There was established, that using MDCTA and a direct morphometry it is possible to gain a highly informative quantitative data on anatomic dimensions of the arteries investigated (the square under the ROC-curve equaled 0.994 and 0.875 accordingly), if to rely on statistically trustworthy results of the diagnostic tests quality in accordance to the experts scale of classificators.
Conclusion. MDCTA has high significance in diagnosis of atherosclerotic plucks, but it may not be regarded a «golden standard» for differentiation of the atherosclerosis stages in patients, suffering diabetic angiopathy. Direct morphometry of arterial structures of the diabetic foot gave away the concerning operating characteristics of MDCTA because of complexity of a process of artificial restoration of the arterial bed hemostasisa, what have impacted the state of the anatomic structures investigated.
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