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Araştırma Makalesi
BibTex RIS Kaynak Göster

Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation

Yıl 2017, Cilt: 2 Sayı: 2, 5 - 11, 18.08.2017

Yusuf Ziya Tan , Semra Özdemir , Gürhan Adam Burak Kaymaz

https://doi.org/10.22391/920.323117

Öz

Introduction: No method alone
is enough to take the amputation decision in the lower extremity. Therefore, in
our study, the contribution of organ perfusion scintigraphy to the evaluation
of lower extremity perfusion was investigated.

Methods:  Our study was retrospectively designed and
investigated patients applying for evaluation before amputation, and with Tc-99m
sestamibi organ perfusion scintigraphy performed. The research included a total
of 21 patients (18 male, 3 female, mean age 67.2 ± 10.6 years). The patients
had OPS results and the results of other investigation methods (DUSG and CTA)
comparatively evaluated. Statistically the diagnostic value of OPS was compared
with the other investigation methods.

Results:  There was no statistically significant
difference between patients in both groups in terms of demographic data, risk
factors and accompanying diseases. Twenty-one patients had both OPS and DUSG
performed while only eleven patients had CTA performed. The results of the
evaluations found that 5 of the 21 patients had amputation performed. The
results were positive in all three tests of amputated patients.







Conclusion:  Considering that peripheral arterial disease
is a functional problem, it is understood that weighted morphological and
limited hemodynamic data are inadequate for clinical evaluation and therefore
physiological and functional examination methods are needed. For this reason,
OPS is a valuable nuclear medicine method that can be used additionally in
patients with amputation planned especially in the evaluation of lower extreme
perfusion.

Anahtar Kelimeler

amputation Lower extremity peripheral artery disease Technetium Tc 99m Sestamibi perfusion scintigraphy radionuclide imaging doppler ultrasonography radiographic tomography digital subtraction angiography

Kaynakça

  • Welten GM, Schouten O, Chonchol M, Hoeks SE, Bax JJ, Van Domburg RT, et al. Prognosis of patients with peripheral arterial disease. J Cardiovasc Surg (Torino) 2009;50:109-21
  • Gardner AW, Afaq A. Management of lower extremity peripheral arterial disease. J Cardiopulm Rehabil Prev 2008;28:349-57
  • Shammas NW. Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. Vasc Health Risk Manag 2007;3:229-34.
  • E. Faglia,G. Clerici, J. Clerissi,L. Gabrielli,S. Losa,M. Mantero,M. Caminiti,V. Curci,T. Lupattelli and A. Morabito. Early and Five-year Amputation and Survival Rate of Diabetic Patients with Critical Limb Ischemia: Data of a Cohort Study of 564 Patients. Eur J Vasc Endovasc Surg . 2006; 32; 484-490
  • Amy W. Pollak, Patrick T. Norton, Christopher M. Kramer.Multimodality Imaging of Lower Extremity Peripheral Arterial Disease Current Role and Future Directions. Circ Cardiovasc Imaging. 2012;5:797-807
  • Tendera M, Aboyens V, Bartelink ML, Baumgartner I, Clement D, Collet JP, Cremonesi A, et al.ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J. 2011 Nov;32(22):2851-906
  • Wolfram RM, Budinsky AC, Sinzinger H: Assessment of peripheral arterial vascular disease with radionuclide techniques. Semin Nucl Med. 2001; 31 :129-142
  • Miles KA, Barber RW, Wraight EP, Cooper M, Appleton DS. Leg muscle scintigraphy with 99Tcm-MIBI in the assessment of peripheral vascular (arterial) disease. Nucl Med Commun 1992; 13: 593-603
  • Kuśmierek J, Dabrowski J, Bieńkiewicz M, Szumiński R, Płachcińska. A Radionuclide assessment of lower limb perfusion using 99mTc-MIBI in early stages of atherosclerosis. Nucl Med Rev Cent East Eur. 2006; 9: 18-23
  • Stacy MR, Zhou W, and Sinusas AJ. Radiotracer Imaging of Peripheral Vascular Disease. J Nucl Med 2013; 54:2104–2110
  • Kramer CM. Skeletal Muscle Perfusion in Peripheral Arterial Disease. JACC: Cardivascular Imaging 2008; vol:1, no:3: 351-353
  • Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. AHA Scientific StatementMeasurement and Interpretation of the Ankle-Brachial Index: A Scientific Statement From the American Heart Association. Circulation 2012;126:2890-2909
  • Celen YZ, Zincirkeser S, Akdemir I, Yilmaz M. Investigation of perfusion reserve using 99Tc(m)-MIBI in the lower limbs of diabetic patients. Nucl Med Commun 2000 Sep;21(9):817-22
  • Lin CC, Ding HJ, Chen YW, Huang WT, Kao A. Usefulness of thallium-201 muscle perfusion scan to investigate perfusion reserve in the olwer limbs of Type 2 diabetes patients. J Diabetes Complications 2004 Jul-Aug;18(4):233-6
  • Duet M,M. Virally M,O. Baillart O, Kevorkian JP, Kedra AW, Benelhadj S, et al. Whole-body 201Tl scintigraphy can detect exercise lower limb perfusion abnormalities in asymptomatic diabetic patients with normal Doppler pressure indices.Nuclear Medicine Communications 2001;22(9):949-954
  • Segal GM, Lang EV, Lennon SE and Stevick CD. Functional Imaging of Peripheral Vascular Disease: A Comparison Between Exercise Whole Body Thallium Perfusion Imaging and Contrast Arteriography. J Nucl Med.1992 Oct;33(10):1797-800
  • Chin AS, Rubin GD. CT Angiography of Peripheral Arterial Occlusive Disease. Techniques in Vascular and Interventional Radiology2006 ;9(4):143–149
  • Meyersohn NM, Walker TG, Oliveira GR. Advances in axial imaging of peripheral vascular disease. Curr Cardiol Rep 2015; 17: 87
  • Verim S,Taşçı İ. Doppler ultrasonography in lower extremity peripheral arterial disease. Arch Turk Soc Cardiol 2013;41(3):248-255
  • Rasheed R. Molecular Perfusion Imaging with 99mTc-MIBI Lower Limb Muscle SPECT: In Diagnosis and Follow up of Peripheral Arterial Diseases (PAD). J Diabetes Metab 2015,;6:3

Amputasyon planlanan hastaların ekstremite perfüzyonunun değerlendirilmesinde radyonüklid organ perfüzyon sintigrafisinin değerlendirilmesi

Yıl 2017, Cilt: 2 Sayı: 2, 5 - 11, 18.08.2017

Yusuf Ziya Tan , Semra Özdemir , Gürhan Adam Burak Kaymaz

https://doi.org/10.22391/920.323117

Öz

Giriş:
Alt
ekstremitelerin amputasyonuna  karar
vermede tek bir yöntem yeterli değildir. Bu nedenle, çalışmamızda, alt
ekstermite değerlendirilmesinde Organ Perfüzyon Sintigrafisinin(OPS) katkısı
araştırıldı.

Yöntem: Çalışmamız
retrospektif olarak düzenlenmiş olup kliniğimize Ortopedi Kliniği tarafından
amputasyon öncesi değerlendirme amaçlı başvuran ve Tc-99m sestamibi organ
perfüzyon sintigrafisi yapılmış hastalar incelendi. Araştırmaya total olarak 21
hasta (18 erkek ve 3 kadın, yaş ortalamaları 67,2 ± 10,6) dahil edildi.
Hastaların Tc-99m sestamibi Organ Perfüzyon Sintigrafisi sonuçları ile diğer
inceleme yöntemleri (Dopler USG ve BTAnjio) ile karşılık olarak
değerlendirildi. İstatiksel olarak OPS'nin tanı değeri diğer inceleme
yöntemleri ile karşılaştırıldı.

Bulgular: Her iki gruptaki
hastalar arasında demografik veriler, risk faktörleri ve eşlik eden hastalıklar
açısından istatistiksel olarak anlamlı fark yoktu. Yirmi bir hastaya hem OPS
hem de DUSG uygulanırken, sadece onbir hastada CTA yapıldı. Değerlendirmeler
sonucunda, 21 hastanın 5'inde amputasyon gerçekleştirildi. Ampute edilen
hastaların her üç testinde de sonuçlar pozitif saptandı.







Sonuç: Periferik arter
hastalığının fonksiyonel bir sorun olduğu göz önüne alınırsa ağırlıklı
morfolojik ve sınırlı hemodinamik verilerin klinik değerlendirme açısından
yetersiz olduğu ve bu nedenle de fizyolojik ve fonksiyonel inceleme
yöntemlerine ihtiyaç bulunduğu anlaşılmaktadır. Bu nedenle de OPS özellikte alt
ekstreme perfüzyonun değerlerlendirilmesinde özellikle amputasyon planlanan
hastalarda ilave olarak faydalanılabilecek değerli bir nükleer tıp yöntemidir.

Anahtar Kelimeler

Alt ekstremite periferik arter hastalığı amputasyon teknesyum Tc 99m Sestamibi perfüzyon sintigrafisi radyonüklid görüntüleme dopler ultrason radyografik tomografi dijital kesit anjiografi

Kaynakça

  • Welten GM, Schouten O, Chonchol M, Hoeks SE, Bax JJ, Van Domburg RT, et al. Prognosis of patients with peripheral arterial disease. J Cardiovasc Surg (Torino) 2009;50:109-21
  • Gardner AW, Afaq A. Management of lower extremity peripheral arterial disease. J Cardiopulm Rehabil Prev 2008;28:349-57
  • Shammas NW. Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. Vasc Health Risk Manag 2007;3:229-34.
  • E. Faglia,G. Clerici, J. Clerissi,L. Gabrielli,S. Losa,M. Mantero,M. Caminiti,V. Curci,T. Lupattelli and A. Morabito. Early and Five-year Amputation and Survival Rate of Diabetic Patients with Critical Limb Ischemia: Data of a Cohort Study of 564 Patients. Eur J Vasc Endovasc Surg . 2006; 32; 484-490
  • Amy W. Pollak, Patrick T. Norton, Christopher M. Kramer.Multimodality Imaging of Lower Extremity Peripheral Arterial Disease Current Role and Future Directions. Circ Cardiovasc Imaging. 2012;5:797-807
  • Tendera M, Aboyens V, Bartelink ML, Baumgartner I, Clement D, Collet JP, Cremonesi A, et al.ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J. 2011 Nov;32(22):2851-906
  • Wolfram RM, Budinsky AC, Sinzinger H: Assessment of peripheral arterial vascular disease with radionuclide techniques. Semin Nucl Med. 2001; 31 :129-142
  • Miles KA, Barber RW, Wraight EP, Cooper M, Appleton DS. Leg muscle scintigraphy with 99Tcm-MIBI in the assessment of peripheral vascular (arterial) disease. Nucl Med Commun 1992; 13: 593-603
  • Kuśmierek J, Dabrowski J, Bieńkiewicz M, Szumiński R, Płachcińska. A Radionuclide assessment of lower limb perfusion using 99mTc-MIBI in early stages of atherosclerosis. Nucl Med Rev Cent East Eur. 2006; 9: 18-23
  • Stacy MR, Zhou W, and Sinusas AJ. Radiotracer Imaging of Peripheral Vascular Disease. J Nucl Med 2013; 54:2104–2110
  • Kramer CM. Skeletal Muscle Perfusion in Peripheral Arterial Disease. JACC: Cardivascular Imaging 2008; vol:1, no:3: 351-353
  • Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. AHA Scientific StatementMeasurement and Interpretation of the Ankle-Brachial Index: A Scientific Statement From the American Heart Association. Circulation 2012;126:2890-2909
  • Celen YZ, Zincirkeser S, Akdemir I, Yilmaz M. Investigation of perfusion reserve using 99Tc(m)-MIBI in the lower limbs of diabetic patients. Nucl Med Commun 2000 Sep;21(9):817-22
  • Lin CC, Ding HJ, Chen YW, Huang WT, Kao A. Usefulness of thallium-201 muscle perfusion scan to investigate perfusion reserve in the olwer limbs of Type 2 diabetes patients. J Diabetes Complications 2004 Jul-Aug;18(4):233-6
  • Duet M,M. Virally M,O. Baillart O, Kevorkian JP, Kedra AW, Benelhadj S, et al. Whole-body 201Tl scintigraphy can detect exercise lower limb perfusion abnormalities in asymptomatic diabetic patients with normal Doppler pressure indices.Nuclear Medicine Communications 2001;22(9):949-954
  • Segal GM, Lang EV, Lennon SE and Stevick CD. Functional Imaging of Peripheral Vascular Disease: A Comparison Between Exercise Whole Body Thallium Perfusion Imaging and Contrast Arteriography. J Nucl Med.1992 Oct;33(10):1797-800
  • Chin AS, Rubin GD. CT Angiography of Peripheral Arterial Occlusive Disease. Techniques in Vascular and Interventional Radiology2006 ;9(4):143–149
  • Meyersohn NM, Walker TG, Oliveira GR. Advances in axial imaging of peripheral vascular disease. Curr Cardiol Rep 2015; 17: 87
  • Verim S,Taşçı İ. Doppler ultrasonography in lower extremity peripheral arterial disease. Arch Turk Soc Cardiol 2013;41(3):248-255
  • Rasheed R. Molecular Perfusion Imaging with 99mTc-MIBI Lower Limb Muscle SPECT: In Diagnosis and Follow up of Peripheral Arterial Diseases (PAD). J Diabetes Metab 2015,;6:3
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Yusuf Ziya Tan 0000-0002-8503-8563

Semra Özdemir

Gürhan Adam

Burak Kaymaz 0000-0001-6207-8063

Yayımlanma Tarihi 18 Ağustos 2017
Gönderilme Tarihi 22 Haziran 2017
Kabul Tarihi 3 Ağustos 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 2 Sayı: 2

Kaynak Göster

APA Tan, Y. Z., Özdemir, S., Adam, G., Kaymaz, B. (2017). Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation. Family Practice and Palliative Care, 2(2), 5-11. https://doi.org/10.22391/920.323117
AMA Tan YZ, Özdemir S, Adam G, Kaymaz B. Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation. Fam Pract Palliat Care. Ağustos 2017;2(2):5-11. doi:10.22391/920.323117
Chicago Tan, Yusuf Ziya, Semra Özdemir, Gürhan Adam, ve Burak Kaymaz. “Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation”. Family Practice and Palliative Care 2, sy. 2 (Ağustos 2017): 5-11. https://doi.org/10.22391/920.323117.
EndNote Tan YZ, Özdemir S, Adam G, Kaymaz B (01 Ağustos 2017) Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation. Family Practice and Palliative Care 2 2 5–11.
IEEE Y. Z. Tan, S. Özdemir, G. Adam, ve B. Kaymaz, “Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation”, Fam Pract Palliat Care, c. 2, sy. 2, ss. 5–11, 2017, doi: 10.22391/920.323117.
ISNAD Tan, Yusuf Ziya vd. “Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation”. Family Practice and Palliative Care 2/2 (Ağustos2017), 5-11. https://doi.org/10.22391/920.323117.
JAMA Tan YZ, Özdemir S, Adam G, Kaymaz B. Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation. Fam Pract Palliat Care. 2017;2:5–11.
MLA Tan, Yusuf Ziya vd. “Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation”. Family Practice and Palliative Care, c. 2, sy. 2, 2017, ss. 5-11, doi:10.22391/920.323117.
Vancouver Tan YZ, Özdemir S, Adam G, Kaymaz B. Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation. Fam Pract Palliat Care. 2017;2(2):5-11.
 Kapak Resmi İndir

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505