Clinical Value Of Ultrasonography In Detection Of Pancreas And Dorsalis Pedis Artery In Diabetic Patient

Objective: To explore the clinical value of ultrasonography in the detection of pancreas and dorsalis pedis artery in type 2 diabetic patient.Methods: Dorsalis pedis artery and pancreas were detected in 60 healthy adults and 80 patients with type 2 diabetes mellitus by color Doppler ultrasonography. The type 2 diabetic patients were divided into two groups according to the duration of the disease: I, < 10 years; II,≥10 years. The type 2 diabetic patients were divided into two groups according to the Random Plasma Glucose (RPG): A, RPG < 15 mmol/l; B, RPG≥15mmol/l. Two-Dimentional ultrasound was used to observe the courser of blood vessel, the echo intensity and thickness of blood vessel wall, the smooth level of endomembrane and the inner diameter of vascular cavities. Color Doppler Flow Imaging (CDFI) was used to observe the colored blood stream signal condition. Pulsed Wave Doppler (PW) was used to measure the peak systolic velocity (Vs), the peak diastolic velocity (Vd), the resistent index (RI) and the pulsatility index (PI). Two-Dimentional ultrasound was used to examine the acoustic images of pancreas and measure the size of pancreas. The echo intensity of pancreas was compared by histogram technique. These results were analyzed by SPSS 13.0 statistical software package. These groups were dealt with ANOVA or Independent- Samples T Test. The correlation between the ultrasonometry parameter of dorsalis pedis artery and the echo intensity of pancreas was explored by linear correlation .Results: In the normal control group, dorsalis pedis artery wall was smooth, thin and consecutive. CDFI displayed filling well blood flow, PW displayed three peaks, narrow frequency band. In the patient group, dorsalis pedis arterial wall became thick, rough and rigid. The atherosclerotic plaques were found inside vascular walls in the part of patient group. The vascular cavities in patients remarkably narrowed compared with the control group. PW in the majority of patients displayed two peaks, in the minority of patients displayed three-peak. The Vs and Vd of dorsalis pedis artery in type 2 diabetic patient were significantly reduced than those in healthy adults (P < 0.05), and the RI and PI were significantly accresed (P < 0.01). The sizes of the pancreas (head, body and tail) in type 2 diabetic patients were noticeabley smaller than those in the controls. The echo intensity of pancreas was significantly higher than that in healthy adults (P < 0.001). Significant differences were found between two groups classified by the duration of the disease and blood glucose (P < 0.05). The correlation analysis showed that: There was positive correlation between the echo intensity of pancreas and RI(r = 0.537, P < 0.01); There was negative correlation between the echo intensity of pancreas and Vs (r = -0.722, P < 0.001); There was negative correlation between the echo intensity of pancreas and Vd (r = -0.697, P < 0.001); and there was no correlation between the echo intensity of pancreas and PI.Conclusions: Ultrasonography can assess the pathological changes in pancreatic parenchyma and dorsalis pedis artery along with the extension of the duration of the disease and the raise of blood glucose in patients with type 2 diabetes accurately and objectively. CDFI can estimate the degree of vascular lesion and the changes of hemodynamics of dorsalis pedis artery accurately. Ultrasound examination is valuable in the evaluation of the diabetes, especially at the early stage of artery diseases in asymptomatic patients. It can provide a more reliable diagnostic data for early asymptomatic patients.