Macrovascular and Microvascular Perfusion of Ischemic Diabetic Ulcers Using MRI (H-41177)

The American Diabetes Association estimates that 25.8 million individuals or 8.3% of the United States population have diabetes mellitus. Individuals with diabetes have an increased risk for cardiovascular disease (CVD) and CVD events account for over 60% of all deaths in diabetics. Approximately 25% of diabetics will develop a lower extremity or foot ulcer during their lifetime. Diabetic foot ulcers occur at an annual rate of 1.5 to 4% and result in significant rates of hospitalization. Diabetics with PAD and lower extremity ulcers have a 3-fold increased mortality rate compared to diabetics without PAD. Advances in endovascular therapy have reduced risks associated with intervention, enabling revascularization as a routine procedure in patients with lower extremity ischemia. Our longitudinal imaging study will assess the ability of MRI-based macrovascular (vessel patency) and microvascular measures to prospectively identify the wound healing status in patients with ischemic diabetic ulcers. The results of the proposed MR imaging assessment may be of interest for the planning of revascularization procedures and for assessing post-intervention symptoms.

Inclusion criteria:
Age 18 or older
Patients with symptoms of intermittent claudication
Patients who are candidates for lower extremity revascularization.

Exclusion criteria:
Patients with non-atherosclerosis disease responsible for claudication
Unstable cardiac disease
History of pancreatitis
Chronic hepatic disease
Patients has an implant which would exclude MRI testing (for example: pacemaker, insulin pump,etc.)
Patient is a past recipient of a cardiac, kidney, liver, lung, or other organ transplant. (Skin grafts are acceptable).