N Manevska1, S Stojanoski2, D Pop Gjorceva2, L Todorovska3, M Vavlukis4, V Majstorov2. 1. Institute of Pathophysiology and Nuclear Medicine, Medical Faculty, University of «Ss. Cyril and Methodius», Skopje, Macedonia. Electronic address: dr.nmanevska@gmail.com. 2. Institute of Pathophysiology and Nuclear Medicine, Medical Faculty, University of «Ss. Cyril and Methodius», Skopje, Macedonia. 3. Institute of Medical Physiology and Antropology, Medical Faculty, University of «Ss. Cyril and Methodius», Skopje, Macedonia. 4. Clinic of Cardiology, Medical Faculty, University of «Ss. Cyril and Methodius», Skopje, Macedonia.
Abstract
AIM: To determine the perfusion reserve of the lower limbs using the method 99mTc-MIBI (rest-dipyridamole) perfusion scintigraphy (one-day protocol) in the diagnostic evaluation of peripheral artery disease (PAD) in patients with and without diabetes mellitus (DM). MATERIAL AND METHODS: We performed tissue-muscle perfusion scintigraphy (TMPS) of the lower limbs, through one-day rest-dipyridamole protocol with 99mTc-MIBI in 24 patients, divided in two groups according to the presence of diabetes - patients with DM (Dp) 13/24 (54%), 2 males and 9 female patients, age 63±13 years and patients without DM (NDp) 11/24 (46%), 3 males and 10 females, age 61±14 years. RESULTS: In the dynamic phase of the rest study, the time of maximum activity (Tmax), in the early arterial phase, of the calf region was significantly prolonged in Dp compared to NDp, with lower accumulation of the radiotracer in the 1st minute (85%/87% in Dp vs. 89%/90% in NDp, ns). 4/11 of NDp (36.4%) and 7/13 of Dp (53.8%) registered pathological value of the inter-extremity index of the calves in the stress study. Perfusion reserve (PR) of the thighs (LT, RT) and calves (LC, RC) calculated with the formula "(ROI stress-ROI rest)×100%/ROI rest", was significantly lower in Dp: LT: 28±19% vs. 43±24% in NDp, p<0.05; RT: 27±17% vs. 40±25% in NDp, p<0.05; LC: 22±15% vs. 36±15% in NDp, p<0.01; RC: 25±15% vs. 38±14% in NDp, p<0.01. CONCLUSION: This one-day protocol (rest-dipyridamole with 99mTc-MIBI) of perfusion scintigraphy of lower limbs is considered as a useful procedure in PAD assessment, especially the asymptomatic form. TMPS of the lower limbs in our study indicated that perfusion reserve in patients with DM was significantly lower, compared to the patients without diabetes.
AIM: To determine the perfusion reserve of the lower limbs using the method 99mTc-MIBI (rest-dipyridamole) perfusion scintigraphy (one-day protocol) in the diagnostic evaluation of peripheral artery disease (PAD) in patients with and without diabetes mellitus (DM). MATERIAL AND METHODS: We performed tissue-muscle perfusion scintigraphy (TMPS) of the lower limbs, through one-day rest-dipyridamole protocol with 99mTc-MIBI in 24 patients, divided in two groups according to the presence of diabetes - patients with DM (Dp) 13/24 (54%), 2 males and 9 female patients, age 63±13 years and patients without DM (NDp) 11/24 (46%), 3 males and 10 females, age 61±14 years. RESULTS: In the dynamic phase of the rest study, the time of maximum activity (Tmax), in the early arterial phase, of the calf region was significantly prolonged in Dp compared to NDp, with lower accumulation of the radiotracer in the 1st minute (85%/87% in Dp vs. 89%/90% in NDp, ns). 4/11 of NDp (36.4%) and 7/13 of Dp (53.8%) registered pathological value of the inter-extremity index of the calves in the stress study. Perfusion reserve (PR) of the thighs (LT, RT) and calves (LC, RC) calculated with the formula "(ROI stress-ROI rest)×100%/ROI rest", was significantly lower in Dp: LT: 28±19% vs. 43±24% in NDp, p<0.05; RT: 27±17% vs. 40±25% in NDp, p<0.05; LC: 22±15% vs. 36±15% in NDp, p<0.01; RC: 25±15% vs. 38±14% in NDp, p<0.01. CONCLUSION: This one-day protocol (rest-dipyridamole with 99mTc-MIBI) of perfusion scintigraphy of lower limbs is considered as a useful procedure in PAD assessment, especially the asymptomatic form. TMPS of the lower limbs in our study indicated that perfusion reserve in patients with DM was significantly lower, compared to the patients without diabetes.