Lower limb tissue muscle 99m-MIBI perfusion scintigraphy in diabetic and non-diabetic patients
Journal
European Journal of Nuclear Medicine and Molecular Imaging
Date Issued
2018-10
Author(s)
DOI
10.1007/s00259-018-4148-3
Abstract
Introduction: Peripheral artery disease in patients with diabe-
tes mellitus (DM) is insufficiently explored. The aim of our study
was to correlate the Doppler ultrasonography, pedo-brachi-
al index and CT-angiography with perfusion reserve of lower
limbs in diabetic patients (pts). Materials and Methods: 60 pts
with DM, age 30 to 70 years, average age of 61.8 ± 10.5 years,
with a duration of diabetes over 5 years. Doppler ulstrasonog-
raphy and pedo-brachial index (PBI) measurement were per-
formed and afterwards tissue-muscle perfusion scintigraphy
with 99m
Tc-MIBI. CT-angiography was performed in 20 diabetic
pts. Results: Significantly lower average value of the perfusion
reserve (PR) was registered in diabetic group, where the Dop-
pler finding demonstrated obstruction of aa. tibialis posterior
bill. or obstruction of aa. dorsalis pedis. PR of left calf (LC): 33.1
± 14.6% vs. 46.93 ± 11.3%, p = 0.0001, while for the right calf
(RC): 33.62% ± 9.5 vs. 46.0 ± 9.3%, p = 0.000004 in pts with ob-
struction of aa.tibialis post. bill. PR for LC was 31.85% ± 16.2 vs.
47.12 ± 8.7, p = 0.000018, while for the RC: 32.93 ± 9.5 vs. 45.82± 8.9, p = 0.000001 (pts with obstruction of aa.dorsalis pedis).
Lower values of PR was obtained in pts with reduced PBI, as
well as Meckenberg sclerosis compared to subjects with nor-
mal PBI. CT-angiography positively correlated with perfusion
scintigraphy - 71.43% of pts with pathological findings on CTA
had lower PR, while perfusion scintigraphy detected microcircu-
latory changes in 28.57% of pts (showing lower PR) when CTA
finding was normal. Conclusion: The scintigraphic method can
earlier estimate microcirculatory disorders than Doppler ultra-
sonographic findings and CTA and may help in evaluating the
perfusion status in individuals with Meckenberg sclerosis. Key
words: muscle perfusion, diabetes, perfusion reserve, Doppler,
pedo-brachial index, CT-angiography
tes mellitus (DM) is insufficiently explored. The aim of our study
was to correlate the Doppler ultrasonography, pedo-brachi-
al index and CT-angiography with perfusion reserve of lower
limbs in diabetic patients (pts). Materials and Methods: 60 pts
with DM, age 30 to 70 years, average age of 61.8 ± 10.5 years,
with a duration of diabetes over 5 years. Doppler ulstrasonog-
raphy and pedo-brachial index (PBI) measurement were per-
formed and afterwards tissue-muscle perfusion scintigraphy
with 99m
Tc-MIBI. CT-angiography was performed in 20 diabetic
pts. Results: Significantly lower average value of the perfusion
reserve (PR) was registered in diabetic group, where the Dop-
pler finding demonstrated obstruction of aa. tibialis posterior
bill. or obstruction of aa. dorsalis pedis. PR of left calf (LC): 33.1
± 14.6% vs. 46.93 ± 11.3%, p = 0.0001, while for the right calf
(RC): 33.62% ± 9.5 vs. 46.0 ± 9.3%, p = 0.000004 in pts with ob-
struction of aa.tibialis post. bill. PR for LC was 31.85% ± 16.2 vs.
47.12 ± 8.7, p = 0.000018, while for the RC: 32.93 ± 9.5 vs. 45.82± 8.9, p = 0.000001 (pts with obstruction of aa.dorsalis pedis).
Lower values of PR was obtained in pts with reduced PBI, as
well as Meckenberg sclerosis compared to subjects with nor-
mal PBI. CT-angiography positively correlated with perfusion
scintigraphy - 71.43% of pts with pathological findings on CTA
had lower PR, while perfusion scintigraphy detected microcircu-
latory changes in 28.57% of pts (showing lower PR) when CTA
finding was normal. Conclusion: The scintigraphic method can
earlier estimate microcirculatory disorders than Doppler ultra-
sonographic findings and CTA and may help in evaluating the
perfusion status in individuals with Meckenberg sclerosis. Key
words: muscle perfusion, diabetes, perfusion reserve, Doppler,
pedo-brachial index, CT-angiography