^(99m)Tc-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

Assessment of Perfusion Reserve of Lower Limbs by Using ^(99m)Tc-MIBI Scintigraphy in Type 2 Diabetes Patients without Symptoms of Peripheral Ischemia

目的:采用^(99m)Tc-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^(99m)Tc-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,^(99m)Tc-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。

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-MlBI 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,HbAlc,HDL,LDL and TG. Conclusion： 9^99mTc-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.