Diabetes-specific characteristics of atherosclerotic plaques in femoral arteries determined by three-dimensional magnetic resonance vessel wall imaging

Objectives This study aimed to investigate the characteristics of femoral atherosclerotic plaques in patients with diabetes mellitus (DM) compared with those without DM using three-dimensional magnetic resonance vessel wall imaging. Methods Lower extremity atherosclerotic disease patients with and without DM (age >= 50 year-old) were recruited and underwent three-dimensional magnetic resonance imaging for femoral arteries. The femoral arteries were divided into common femoral artery (CFA), proximal of superficial femoral artery (pSFA), adductor canal (AC), and popliteal artery (PA) segments. The characteristics of femoral artery atherosclerotic plaques were compared between patients with and without DM. Results Forty-eight patients with DM (69.5 +/- 8.2 years; 26 males) and 50 patients without DM (71.9 +/- 5.7 years; 28 males) were included. Significant differences were found in maximum wall thickness in CFA and AC segments, eccentricity index in AC segment, prevalence of plaque in CFA, pSFA and AC segments, stenosis and prevalence of calcification in pSFA, AC and PA segments, prevalence of lipid-rich necrotic core (LRNC) in all segments, and prevalence of intraplaque haemorrhage in PA segment between patients with and without DM (all P < .05). After adjusted for confounding factors of age, gender, hyperlipidemia, coronary artery disease, and statin use, the differences in eccentricity index, stenosis and prevalence of plaque, calcification and LRNC in pSFA and AC segments, and stenosis and prevalence of LRNC in PA segment remained statistically significant between patients with and without DM (all P < .05). Conclusions Patients with DM have significantly larger plaque burden, higher prevalence of plaques, and more complex plaque compositions in femoral arteries than those without DM.