Document Detail


Preamputation evaluation of lower-limb skeletal muscle perfusion with H(2) (15)O positron emission tomography.
MedLine Citation:
PMID:  20357647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To establish whether muscle blood flow (MBF) measurements with O-water positron emission tomography could reliably identify patients with critical limb ischemia and detect and quantify a distal deficit in skeletal MBF in these cases. DESIGN: O-water positron emission tomography scans were performed at rest or during unloaded ankle plantar and dorsiflexion exercise of the diseased leg in 17 subjects with leg ischemia or on a randomly selected leg of 18 age-matched healthy control subjects. TcPO2 was evaluated with Novametrix monitors and perfusion of skin topically heated to 44 degrees C and adjacent nonheated areas with a Moor Instruments laser Doppler imaging scanner. RESULTS: The enhancement of MBF induced by exercise was significantly lower in ischemic than in normal legs, and the sensitivity and specificity of this phenomenon were similar to those of laser Doppler imaging or TcPO2 in identifying ischemia subjects. In addition, the exercise MBF deficit was predominant at the distal-leg levels, indicating the ability of the technique to help determine the correct level of amputation. CONCLUSIONS: Skeletal MBF of legs with severe ischemia can be detected accurately with O-water positron emission tomography and could add valuable information about viability of skeletal muscle in the residual limb when deciding the level of an amputation.
Authors:
Oscar U Scremin; Stephen F Figoni; Keith Norman; A M Erika Scremin; Charles F Kunkel; Dorene Opava-Rutter; Eric D Schmitter; Alberto Bert; Mark Mandelkern
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  89     ISSN:  1537-7385     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  473-86     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amputation / methods
Analysis of Variance
Case-Control Studies
Female
Humans
Ischemia / diagnosis,  radionuclide imaging*,  surgery
Laser-Doppler Flowmetry / methods
Leg / blood supply*,  surgery
Male
Middle Aged
Muscle Contraction / physiology
Muscle, Skeletal / blood supply*,  radionuclide imaging*
Positron-Emission Tomography / methods*
Preoperative Care / methods
Probability
Radioactive Tracers
Regional Blood Flow
Sensitivity and Specificity
Water
Chemical
Reg. No./Substance:
0/Radioactive Tracers; 7732-18-5/Water

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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