Noninvasive Evaluation for the Therapeutic Effect Using Thallium-201 in the Ischemic Foot

Publisher Website
Google Scholar
Abstract
Arterial insufficiency of the foot was examined by radioisotope study with intravenous administration of thallium-201. We observed the immediate distri bution during postocclusive reactive hyperemia and the redistribution in the foot after a 3 hours interval. Seventy-seven feet were examined: 18 normal feet, 24 feet with claudication, 31 feet with rest pain or ischemic ulcers, 4 feet with diabetic ulcers. The distribution index (D.I.), which defined the ratio of uptake counts of the immediate distribution to those of the redistribution, was of use to evaluate quantitively the degree of ischemia. Using these parameters to assess the therapeutic effects, 23 feet with ischemic ulcers were examined before and after treatment.: 5 feet with arterial reconstruction, 4 feet with lumbar sympa thectomy, 14 feet undergoing medical treatment. The effect index (E.I.) was defined as the ratio of the D.I. after treatment to before treatment. When the E.I. value was more than 1.0, 18 of 20 ischemic ulcers were improved and two were unchanged whereas all four ulcers with the E.I. value less than 1.0 became worse. The D.I. is a reliable indicator to estimate the degree of ischemia and the E.I. is of use to predict therapeutic effect particularly following lumbar sympa thectomy or medical treatment, which are frequently difficult to be evaluated by other noninvasive diagnostic methods.