Assessment and Quantification of Regional Arterial Perfusion Reserve in Patients with Peripheral Occlusive and Small-Vessel Disease by Rubidium 82-Positron Emission Tomography

Abstract

The aim of the study was to assess the skeletal muscle blood flow and the regional perfusion reserve by rubidium 82-positron emission tomography (PET) in order to evaluate the functional effects of stenoses and occlusions of lower leg arteries. In 12 patients the authors infused 12 mCi rubidium 82 into the femoral artery (following diagnostic cardiac catheterization) and recorded a dynamic PET sequence of the lower leg at rest and during reactive hyperemia following two minutes of complete arterial blockage by a cuff. Regional perfusion was calculated as the rate of uptake related to the 82 Rb input function. Perfusion reserve was calculated as the regional perfusion during hyperemia related to perfusion at rest. Muscle perfusion at rest was homogeneous in all patients. The regional perfusion reserve was markedly reduced in muscle areas distal to infrapopliteal stenoses or occlusions as compared with muscle areas following nonstenotic arteries and overall reduced in a patient with small-vessel disease. The authors conclude that 82 Rb-PET allows exact measurement of the regional perfusion of the lower leg muscles during rest and reactive hyperemia. Calculation of the regional perfusion reserve gives a quantification of the functional effects of peripheral occlusive artery disease.

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