99mTc-MIBI下肢显像在2型糖尿病下肢血流储备评估中的初步应用

摘要

Purpose:To evaluate the vascular reserves of the lower limbs in type 2 diabetic patients without symptoms of peripheral ischemia by using 99mTc-MIBI scintigraphy.Methods:Thirty-three diabetic patients (mean age 63.39±10.9 years) who had no evidence of peripheral arterial disease history by physical examination or Doppler ultrasonography were enrolled.The control group consisted of 12 non-diabetic patients (mean age 60.3±9.2 years).Each subject flexed their right foot maximally both dorsally and plantar 60 times,and 99mTc-MIBI was injected in the middle of this exercise.Five minutes after the injection,a posterior acquisition of both calves was obtained using SPECT/CT.Total count was obtained by drawing rectangular regions of interest covered both calves.Percentage increase of total count in the exercising calf was calculated by subtracting the rest side.Results:A significant difference was found between the perfusion reserves of the diabetic and control groups (77.9±39.1) ％ and (116.6±37.1) ％,respectively,P=0.005.No correlations were found between vascular reserves with BMI,FBG,HbA 1 c,HDL,LDL and TG.Conclusion:99mTc-MIBI lower limbs scintigraphy can be used to detect early vascular reserve decrease in type 2 diabetic patients without symptoms of peripheral ischemia,and this method can provide a quantitative analysis for peripheral artery diseases.%目的:采用99mTc-MIBI下肢显像方法对无临床外周缺血表现的2型糖尿病患者的下肢血管储备功能进行定量评估.方法:33例入院治疗的2型糖尿病患者(男17例,女16例,平均年龄63.39±10.9岁)和12名非糖尿病对照(男6例,女6例,平均年龄60.3±9.2岁)进行了60次右足最大背屈和跖屈动作中间注射99mTc-MIBI,3min后进行双下肢后位静态采集.测量两侧腓肠肌的放射性计数,并以非运动下肢作为自身对照,计算运动负荷后小腿放射性计数的增加幅度(定义为下肢血管储备系数).结果:糖尿病组下肢血管储备为(77.9±39.1)％,非糖尿病对照组为(116.6±37.1)％.糖尿病组显著低于非糖尿病对照组(P=0.005).糖尿病组下肢血管储备与BMI、FBG、HbA1c、HDL、LDL及TG之间均没有显著相关性(P＞0.05).结论:无临床外周缺血表现的2型糖尿病患者存在下肢血管储备功能的降低,99mTc-MIBI下肢灌注扫描可为外周动脉疾病提供客观的定量分析技术.