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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2000 September;19(3):212-219

lingua: Inglese

Comparison between exercise whole body thallium imaging and ankle-brachial index in the detection of peripheral arterial disease

Tellier P., Aquilanti S., Lecouffe P., Vasseur C.

From the Cen­tre of Nuclear Medicine of Artois (CMNA), Cli­nique ­Sainte Cathe­rine, Arras, ­France


Back­ground. 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.
Meth­ods. Experi­men­tal ­design: pros­pec­tive non­-ran­dom­ised study. Set­ting and ­patients: 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. Meas­ures: 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.
­Results. 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.
Con­clu­sions. 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.

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