A novel use of hill function and utility of 99mTc-MIBI scintigraphy to detect earlier lower extremity microvascular perfusion in patients with type 2 diabetes

We use the Hill function to analyze the dynamics of Tc-99m 2 methoxy-isobutyl-isonitrile (Tc-99m-MIBI) scintigraphy data and to examine the earlier lower extremity microvascular perfusion of diabetic patients without typical clinical symptoms and with the preserved normal ankle-brachial index (ABI). Eighty-eight participants (30 healthy control, 34 diabetic patients, and 24 diabetic patients with peripheral arterial disease [PAD]) were recruited and applied 99mTc-MIBI scintigraphy. Fourteen diabetic patients with PAD also underwent computed tomography angiography (CTA) examination and were performed endovascular interventions. Diabetic patients with normal ABI already have significantly impaired maximum 99mTc-MIBI muscle perfusion counts (P<.001) and the peak times of the lower extremity muscle perfusion (P<. 05). 99mTc-MIBI scintigraphy showed great consistent with ABI and CTA in detecting PAD. 99mTc-MIBI scintigraphy was also found to be effective in evaluating lower extremity circulation after endovascular interventions (P<. 05). Hill function-based analysis of 99mTc-MIBI scintigraphy might be effective method to evaluate earlier lower extremity perfusion changes in diabetic patients.