Role of Computed Tomography Angiography (CTA) and Color Doppler Ultrasonography in Evaluation of Arterial System in Diabetic Foot

Abstract
Objective: The aim of this study was to highlight the role of Computed Tomography Angiography (CTA) and color Doppler Ultrasonography (DUS) in the evaluation of patients with diabetic foot disease.
Background: The risk for ulceration and amputation is much higher in diabetics compared with nondiabetics. CTA is more frequently used to assess peripheral vascular disease of the diabetic foot while Doppler ultrasonograpy is a reliable non-invasive method of investigating the lower limb arterial system provides us with hemodynamic data proximal, distal and at the site of obstruction.
Patients and Methods: This prospective study included 30 diabetic patients who presented with diabetic foot vascular lesions and referred from outpatient clinics of Vascular Surgery Department to the Radiology and Medical Imaging Department, Tanta University Hospital. The present study was performed in the period between March 2017 and March 2018. Their ages ranged from 40 to 80 years; 17 of them were men and 13 were women. All cases underwent Doppler examination as a rapid, noninvasive complementary diagnostic tool, and the findings were compared with those of CTA.
Results: In the present study, the number of segments were 513 for 57 limbs, and each arterial tree of one limb was divided into nine segments (common iliac,external iliac, common femoral, superficial femoral, popliteal, anterior tibial, posterior tibial, peroneal, and dorsalis pedis arteries). In this study, the number of stenotic segments was 30 and 22 on Multidetector Computed Tomography Angiography (MDCTA) and DUS, respectively. The number of segments with total occlusion was 50 and 43 on MDCTA and DUS, respectively.
Conclusion: The use of CTA and DUS increases the ability to delineate vascular anatomy, localize the obstruction, assess the severity of stenosis, and detect the presence of collaterals and distal run off.