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DOI: 10.1055/s-0038-1629636
Quantitative 201T1-Szintigraphie der Unterschenkel bei arterieller Verschlußkrankheit
Quantitative 201TI Scintigraphy of the Lower Limbs in Peripheral Artery DiseasePublication History
Eingegangen:
10 July 1992
04 November 1992
Publication Date:
02 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034924/199301/lookinside/thumbnails/10-1055-s-0038-1629636_de-1.jpg)
Zusammenfassung
Die Szintigraphie mit 201TI kann die hämodynamischen Auswirkungen einer arteriellen Verschlußkrankheit der Beine dokumentieren. Ziel der vorliegenden Studie war die Bestimmung von Normwerten für die absolute 201TI-Aufnahme im Unterschenkel, für das Seitenverhältnis der Aufnahme zwischen rechtem und linkem Unterschenkel und für das Redistributionsverhalten nach Fahrradergometrie. Es wurden 49 Patienten ohne klinischen Anhalt für AVK oder KHK als normales Kontrollkollektiv untersucht: absolute Tl-Aufnahme bei einer Akquisitionszeit von 120 sec von anterior 5,02 ± 1,70 counts/Pixel (links) bzw. 5,21 ± 1,53 counts/Pixel (rechts), Seitenquotient (rechts/links bzw. links/ rechts) 0,85 ± 0,09, Redistributionsquotient (mittlere Aktivität Belastungsaufnahme/Ruheaufnahme) 0,82 ± 0,17 (links) bzw. 0,83 ± 0,15 (rechts). Als unterer Normwert wurde das arithmetische Mittel minus zwei Standardabweichungen festgelegt. Bei 8 Patienten mit mechanischer Kompression der linken A. femoralis lagen mindestens zwei szintigraphische Parameter im pathologischen Bereich. Bei 7 Patienten mit AVK lag wenigstens ein Parameter unterhalb der Norm. Die Einbeziehung des Redistributionsverhaltens bietet bei beidseitigen Gefäßveränderungen diagnostische Vorteile.
Summary
201TI scintigraphy is useful in evaluating the hemodynamic consequences of arterial stenoses in arterial occlusive disease. The aim of the present study was to determine normal values for absolute Tl uptake in the lower leg, for the quotient between left and right lower leg uptake as well as for the redistribution pattern after bicycle exercise. We examined as reference 49 patients without clinical evidence of peripheral or coronary artery disease: absolute Tl uptake in the lower leg in anterior scintigraphy (acquisition time: 120 sec) was 5.02 ± 1.70 counts/pixel (left) and 5.21 ± 1.53 counts/pixel (right), the quotient between right and left lower leg was 0.85 ± 0.09 and the redistribution pattern (quotient of the mean activity exercise/rest) 0.82 ± 0.17 (left) and 0.83 ± 0.15 (right). The arithmetic mean minus 2 standard deviations was regarded as the lower limit of normal. In 8 patients with mechanical compression of the left femoral artery before injection at least two scintigraphic parameters were abnormal, in 7 patients with angiographically proven peripheral artery disease at least one scintigraphic parameter was below normal. Quantification of Tl redistribution offers diagnostic advantages in bilateral peripheral artery disease.
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Literatur
- 1 Amendt K, Köstlin G, Diehm C. et al. Angioszintigraphie mit Krypton-81m bei Patienten mit arterieller Verschlußkrankheit (PAVK). Z Kardiol 1991; 80 (Suppl. 03) 86.
- 2 Burt RW, Mullinix FM, Schauwecker DS. et al. Leg perfusion evaluated by delayed administration of Tl-201. Radiology 1984; 151: 219-24.
- 3 Chevreaud C, Thouvenot P, Lapeyrc G. et al. Thallium-201 muscle scintigraphy: application to the management of patients with arterial occlusive disease. Angiology 1986; 38: 309-14.
- 4 Creutzig A, Luska G, Creutzig H, Alexander K. Vcrlaufskontrolle nach perkutaner transluminaler Rekanalisation peripherer Gefäße mit der Gefäß-Szintigraphie. Vasa 1982; 11: 316-8.
- 5 Creutzig H, Creutzig A, Alexander K, Hundeshagen H. Herz- und Skelettmuskelszintigraphie mit Thallium-201. Z Kardiol 1985; 74: 1-4.
- 6 Depairon M, de Landsheere C, Merlo P. et al. Effect of exercise on the leg distribution of C15O2 and 15O2 in normals and in patients with peripheral ischemia: a study using positron tomography. Int Angiol 1988; 07: 254-7.
- 7 Depairon M, Depresseux JC, Petermans J, Zicot M. Assessment of flow and oxygen delivery to the lower extremity in arterial insufficiency: a PET-scan study. Comparison with other methods. Angiology 1991; 42: 788-95.
- 8 Giargiana FA, Siegel ME, James AE. et al. Preliminary report on the complementary roles of arteriography and perfusion scan- ning in assessment of peripheral vascular disease. Radiology 1973; 108: 619-27.
- 9 Hamanaka D, Odori T, Maeda H. et al. A quantitative assessment of scintigraphy of the legs using 201-T1. Eur J Nucl Med 1984; 09: 12-6.
- 10 Hör G. Myocardial scintigraphy - 25 years after start. Eur J Nucl Med 1988; 13: 619-36.
- 11 Lassen NA, Lindbjerg J, Munck O. Measurement of blood flow through skeletal muscle by intramuscular injection of Xe-133. Lancet 1964; i: 686-9.
- 12 Massa R, Fasano F, Boemi S. et al. Muscular blood supply of the lower limbs: investigation by 99m-Tc-MIBI. J Nucl Med 1989; 33: 157.
- 13 Miles A, Barber RW, Wraight EP. et al. Leg muscle scintigraphy with 99m-Tc-MIBI in the assessment of peripheral vascular (arterial) diesease. Nucl Med Comm 1992; 13: 593-603.
- 14 Müller-Bühl U. Koinzidenz arterieller Verschlußkrankheiten. Herz + Gefäße 1990; 10: 128-31.
- 15 Oshima M, Akanabe H, Sakuma S. et al. Quantification of leg muscle perfusion using thallium-201 single photon emission computed tomography. J Nucl Med 1989; 30: 458-65.
- 16 Pohost GM, Zir LM, Moore RM. et al. Differentiation of transiently ischcmic from infarctcd myocardium by serial imaging after a single dose of thallium-201. Circulation 1977; 55: 294-302.
- 17 Rhodes BA, Greyson ND, Siegel ME. et al. The distribution of radioactive microspheres after intra-arterial injection in the legs of patients with peripheral vascular disease. Am J Roentgenol 1973; 118: 820-6.
- 18 Sapirstein LA. Regional blood flow by fractional distribution of indicators. Am J Physiol 1958; 193: 161-8.
- 19 Seder J, Botvinick EH, Rahimtoola SH. et al. Detecting and localizing peripheral artery disease: assessment of 201-T1 scintigraphy. Am J Roentgenol 1981; 137: 373-80.
- 20 Seder J, Rahimtoola S, Botvinick E. et al. Accurate detection of peripheral artery disease with exercise Tl-201 leg imaging. J Nucl Med 1979; 20: 634.
- 21 Segall GM, Lennon SE, Stevick CD. Exercise whole-body thallium scintigraphy in the diagnosis and evaluation of occlusive arterial disease in the legs. J Nucl Med 1990; 31: 1443-9.
- 22 Siegel ME, Giargiana FA, Rhodes BA. et al. Effect of reactive hyperemia on the distribution of radioactive microspheres in patients with peripheral vascular disease. Am J Roentgenol 1973; 118: 814-9.
- 23 Siegel ME, Giargiana FA, White RI. et al. Peripheral vascular perfusion scanning – correlation with the arteriogram and clinical assessment in the patient with peripheral vascular disease. Am J Roentgenol 1975; 125: 628-35.
- 24 Siegel ME, Siemsen JK. A new noninvasive approach to peripheral vascular disease: Thallium-201 leg scans. Am J Roentgenol 1978; 131: 827-30.
- 25 Siegel ME, Stewart CA, Kwong P, Sakimura I. Tl-201 perfusion study of “ischemic” ulcers of the leg: Prognostic ability compared with Doppler ultrasound. Radiology 1982; 143: 233-5.
- 26 Strauss HW, Harrison K, Pitt B. Thallium- 201: non-invasive determination of the regional distribution of cardiac output. J Nucl Med 1977; 18: 1167-70.