title: Investigating the capillary circulation of the foot with 99mTc-macroaggregated albumin: a prospective study in patients with diabetes and foot ulceration.
abstract: Macroaggregated albumin has been used to assess capillary circulation for over 20 years. The aim of the present study was to use 99mTc-macroaggregated albumin (99mTc-MAA) perfusion scanning to assess capillary circulation in feet with ischaemic ulcers in patients with diabetes, and relate the appearances to outcome. Twenty-three patients with diabetes presented with a total of 41 neuroischaemic foot ulcers. Perfusion scanning was performed by direct femoral artery injection of approximately 400,000 particles of 99mTc-MAA and imaging with a gamma camera. Patients were followed prospectively for 3 months. Scans were graded independently by a radiologist who was unaware of the site of the ulcers. Significant associations were detected between a radiologist's assessment of increased tissue perfusion and complete healing after 3 months (p = 0.047) and poor tissue perfusion on the image and failure to heal (p = 0.0005). This technique may be useful in deciding whether to persist with conservative treatment in patients with diabetes and foot ulceration.
authors.affiliation: Diabetes Unit, Queen's Medical Centre, Nottingham, UK.
authors.forename: K T
authors.initials: KT
authors.lastname: Moriarty
authors.forename: A C
authors.initials: AC
authors.lastname: Perkins
authors.forename: A M
authors.initials: AM
authors.lastname: Robinson
authors.forename: M L
authors.initials: ML
authors.lastname: Wastie
authors.forename: R B
authors.initials: RB
authors.lastname: Tattersall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002196:Capillaries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D017719:Diabetic Foot / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin