The value of tissue Doppler imaging in evaluating the elasticity of femoral artery wall in patients with type 2 diabetes mellitus withe the distal femoral artery blood flow blocked

Objective To study the value of tissue Doppler imaging in evaluating the elasticity of femoral arterial wall in patients with type 2 diabetes mellitus with the distal femoral artery blood flow blocked. Methods From December 2012 to February 2014, 64 patients with T2DM were treated in Shaoxing Second Hospital. Among them, the femoral artery intima media thicknesses (IMT) of 34 patients were <1.0 mm and those of 30 patients were≥1.0 mm. At the same time, 30 healthy persons were selected as healthy control. High frequency ultrasound was used to observe the structure of femoral artery and measure IMT of femoral artery. Pulsed-wave Doppler (PW) technique was used to measure the blood flow spectrum of the femoral artery. After the blood flow of the distal femoral artery was blocked, PW and tissue velocity imaging (TVI) technique were used to measure the motion curve of the posterior wall of the femoral artery, and the first and second peak duration was measured. T test was used to compare the IMT difference between T2DM group with femoral artery IMT<1.0 mm, T2DM group with femoral artery IMT≥1.0 mm and healthy control group. Rank sum test was used to compare the difference between the first and second peak duration of the posterior wall of the femoral artery in the three groups. Results The IMT of healthy control group, T2DM group with femoral artery IMT<1.0 mm and T2DM group with femoral artery IMT≥1.0 mm were (0.80±0.09), (0.82±0.08) and (1.26±0.19) mm , respectively. There was no significant difference in IMT between the T2DM group with femoral artery IMT<1.0 mm and healthy control group (t=1.67, P=0.10). The IMT in T2DM group with femoral artery IMT≥1.0 mm were higher than those in healthy control group, and the difference was statistically significant (t=16.88, P=0.00). The femoral artery blood flow spectrum in 3 groups of subjects were three-phase wave type with a peak and two troughs before the blood flow of the distal femoral artery blocked, which were four-phase wave type with two peaks and two troughs after the blood flow of the distal femoral artery blocked. After the blood flow of the distal femoral artery blocked, the duration of the first peak of the posterior wall of the femoral artery in healthy control group, T2DM group with femoral artery IMT<1.0 mm and T2DM group with femoral artery IMT≥1.0 mm were (220.77±59.07), (250.96±42.62) and (246.55±52.41) ms, respectively. There was no significant difference between the three groups (u=3.258, P=0.196). The duration of the second peak were (209.18±42.99), (272.27±39.98) and (344.71±43.96) ms, respectively. The difference between the 3 groups were statistically significant (u=74.150, P=0.000). Conclusion The second wave duration of the femoral artery posterior wall motion curve can be used as an effective index for the evaluation of the femoral artery elasticity before the IMT changes of the femoral artery wall. Key words: Diabetes mellitus, type 2; Femoral artery; Ultrasonography