Tellier P, Aquilanti S, Lecouffe P, Vasseur C
Centre of Nuclear Medicine of Artois, Clinique Sainte Catherine, Arras, France.
Int Angiol. 2000 Sep;19(3):212-9.
Exercise whole body thallium imaging and rest/exercise ankle-brachial index can provide evidence of peripheral artery disease at the stage of intermittent claudication. The aim of this study was to compare both methods in the detection of asymptomatic peripheral artery disease.
prospective non-randomised study.
general community, private practice, ambulatory patients referred in a Nuclear Medicine Department for exercise myocardial scintigraphy. Intermittent claudication was present in 8% of the whole study population. Coronary artery disease and diabetes were respectively present in 70% and 16% of the same population.
rest/exercise ankle-brachial index and exercise whole body thallium imaging were measured in 105 patients (76 men and 29 women, mean age +/- 1 SD= 61 +/- 10 year) who performed a near-maximal or maximal treadmill test. Normal values of regional blood supply and indices of asymmetry at different levels of legs were determined in 14 patients with a very low probability of peripheral artery disease.
The probability of peripheral artery disease was very high in 19 patients (group 1), because of abnormal rest and/or exercise ankle-brachial index, whereas in the 86 remaining patients, the index at rest and exercise was quite normal (group 2).With respect to rest and/or exercise ankle-brachial index, the sensitivity, specificity, positive and predictive negative value of exercise scintigraphy abnormalities were respectively 89%, 62%, 34% and 96%. The false positive scan group differed from the true positive group only by sex and redistribution of thallium 201. The proportion of diabetic patients was the same (15%) in both groups.
Exercise whole body thallium imaging might contribute without additional cost to the detection, functional evaluation and/or risk stratification of peripheral artery disease in patients who perform exercise myocardial scintigraphy.
运动全身铊显像及静息/运动踝肱指数可在间歇性跛行阶段提供外周动脉疾病的证据。本研究的目的是比较这两种方法在检测无症状外周动脉疾病方面的效果。
前瞻性非随机研究。
普通社区、私人诊所，因运动心肌闪烁显像转诊至核医学科的门诊患者。整个研究人群中8%存在间歇性跛行。同一人群中分别有70%和16%患有冠状动脉疾病和糖尿病。
对105例患者（76例男性和29例女性，平均年龄±1标准差 = 61±10岁）进行了近最大或最大运动平板试验，测量其静息/运动踝肱指数及运动全身铊显像。在14例外周动脉疾病可能性极低的患者中确定了不同腿部水平的局部血供正常值及不对称指数。
19例患者（第1组）外周动脉疾病的可能性非常高，因为静息和/或运动踝肱指数异常，而其余86例患者静息和运动时该指数相当正常（第2组）。就静息和/或运动踝肱指数而言，运动闪烁显像异常的敏感性、特异性、阳性预测值和阴性预测值分别为89%、62%、34%和96%。假阳性扫描组与真阳性组仅在性别和铊201再分布方面存在差异。两组糖尿病患者比例相同（15%）。
对于进行运动心肌闪烁显像的患者，运动全身铊显像可能无需额外费用即可有助于外周动脉疾病的检测、功能评估和/或风险分层。
