Investigation of perfusion reserve using Tc-99(m)-MIBI in the lower limbs of diabetic patients

This study aimed to investigate the microvascular pathology in the lower li mbs of diabetic patients without symptoms or findings of peripheral ischaem ia by measuring perfusion reserve scintigraphically. It was carried out in 47 female subjects who had no evidence of peripheral arterial disease in th eir history, physical examination or Doppler ultrasonography. The diabetic group consisted of 25 women (mean age 54.2+/-3.54 years) with type LT diabe tes mellitus of more than 10 years' duration. A control group consisted of 22 healthy non-diabetic women (mean age 50.14+/-6.75 years). Each subject f lexed their right foot maximally both dorsally and plantar 60 times. In the middle of this exercise, 370 MBq technetium-99m-methoxyisobutylisonitrile (Tc-99(m)-MIBI) was injected intravenously. Ten minutes after the injection , a posterior image of both calves was obtained using a gamma camera. Recta ngular regions of interest were symmetrically drawn over both calves. The t otal count in the resting calf was subtracted from the total count in the e xercising calf, and the percentage increase, termed the perfusion reserve, was determined. A significant difference was found between the perfusion re serves of the diabetic and control groups (76.04+/-12.96% and 95.91+/-12.83 %, respectively; P < 0.001). In conclusion, microvascular pathology may be determined scintigraphically by measuring the perfusion reserve in the lowe r Limb muscles in diabetic patients. This method may also be used to evalua te perfusion abnormalities in other circulatory disorders. ((C) 2000 Lippin cott Williams & Wilkins).