title: Insights Into Microcirculation Underlying Critical Limb Ischemia by Single-Photon Emission Computed Tomography.
abstract: Perfusion difference is used as a parameter to evaluate microcirculation. This study aims to differentiate lower-limb perfusion insufficiency from neuropathy to prevent possible occurrence of failed back surgery syndrome (FBSS).Patients were retrospectively gathered from 134 FBSS cases diagnosed in the past 7 years. Up to 82 cases that were excluded from neuralgia by radiologic imaging, electrodiagnostic electromyography, and nerve conduction velocity were enrolled in this study. Perfusion difference was evaluated by single-photon emission computed tomography, and pain intensities were recorded via visual analog scale (VAS) score.Lower perfusion at the left leg comprises 51.2% (42 of 82) of the patients. The mean perfusion difference of the 82 patients was 0.86 ± 0.05 (range: 0.75-0.93). Patients with systemic vascular diseases exhibited significantly higher perfusion difference than that of patients without these related diseases (P < 0.05), except for renal insufficiency (P = 0.134). Significant correlation was observed between perfusion difference and VAS score (r = -0.78; P < 0.0001; n = 82).In this study, we presented perfusion difference as a parameter for evaluating microcirculation, which cannot be detected by ultrasonography or angiography.
authors.affiliation: From Department of Neurosurgery, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung City, Taiwan (J-TL, C-SC, C-HS, C-SL).
authors.forename: Jung-Tung
authors.initials: JT
authors.lastname: Liu
authors.forename: Cheng-Siu
authors.initials: CS
authors.lastname: Chang
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Su
authors.forename: Cho-Shun
authors.initials: CS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014652:Vascular Diseases / Q000503:physiopathology