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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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