CA2413352A1 - Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection - Google Patents

Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection Download PDF

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Publication number
CA2413352A1
CA2413352A1 CA002413352A CA2413352A CA2413352A1 CA 2413352 A1 CA2413352 A1 CA 2413352A1 CA 002413352 A CA002413352 A CA 002413352A CA 2413352 A CA2413352 A CA 2413352A CA 2413352 A1 CA2413352 A1 CA 2413352A1
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Canada
Prior art keywords
tracer
limb
measuring
limbs
forearms
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Granted
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CA002413352A
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French (fr)
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CA2413352C (en
Inventor
Andre Arsenault
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Individual
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
    • A61B5/02755—Radioactive tracers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/42—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4208—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector
    • A61B6/4258—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector for detecting non x-ray radiation, e.g. gamma radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50—Clinical applications
    • A61B6/507—Clinical applications involving determination of haemodynamic parameters, e.g. perfusion CT
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers

Abstract

Endothelial dysfunction is a known indicator of cornary artery disease. Endothelial dysfunction is detected by measuring tracer presence in arteries following the release of blood flow into the limb after a period of blockage of blood flow into the limb. The blood flow is measured in a pair of lateral ly opposed limbs, such as the patient's forearms, and the tracer presence is compared between both limbs. An efficient tracer is a radionuclide and the n on- invasive measurement of the radionuclide is carried out by gamma ray detecti on.

Claims (30)

1. A method of obtaining data for the diagnosis of endothelial dysfunction comprising the steps of:
blocking blood flow in one limb for a first period of time to stimulate an endothelial function;
releasing the block of blood flow in said one limb;
injecting a bolus of a tracer in a vein such that said bolus is conducted to the heart and evenly distributed to said one limb and an opposed limb via arteries;
measuring a presence of said tracer in said one limb.
2. The method as claimed in claim 1, wherein said measuring tracer presence comprises measuring tracer presence in both said limb and said contra-lateral limb, further comprising comparing tracer presence between both said limbs to provide comparison data.
3. The method as claimed in claim 1 or 2, wherein said tracer comprises a radioactive tracer, said measuring comprises measuring radiation emitted from a region of interest in said limb.
4. The method as claimed in claim 3, further comprising measuring an activity of said bolus prior to injection to establish a reference activity level.
5. The method as claimed in claim 3 or 4, wherein said limbs comprise arms and said region of interest is a forearm.
6. The method as claimed in claim 5, wherein said forearms are placed palms down on a substantially flat surface in order to detect said region of interest of each one of said forearms.
7. The method as claimed in claim 6, wherein said radiation is measured as an image using a gamma camera on which said forearms are placed palms down.
8. The method as claimed in any one of claims 1 to 7, wherein said tracer presence is measured and recorded as a function of time.
9. The method as claimed in any one of claims 1 to 8, wherein said measuring comprises adjusting a position of said limbs with respect to a radiation detector so as to detect radiation with a substantially squat sensitivity for each of said limbs.
10. The method as claimed in any one of claims 1 to 9, wherein diagnosis of endothelial dysfunction is determined from a steady state measurement of said tracer presence.
11. An apparatus for detecting endothelial dysfunction, comprising:
detector means adapted to detect presence of a tracer carried by blood flow into a limb and an opposed, contra-lateral limb;
means for holding said limbs with respect to said detector means; and means for blocking blood flow in only one limb for a first period of time.
12. The apparatus as claimed in claim 11, wherein said detector means and means for holding are adapted to hold both a forearm and a contra-lateral forearm.
13. The apparatus as claimed in claim 11 or 12, wherein said detector means comprise a radiation detector for detecting radiation emitted by a tracer flowing in arteries into said limbs.
14. The apparatus as claimed in claim 12, wherein said detector means comprise a radiation detector, and said means for holding comprise:
a positioning guide for assisting a patient to position forearms in a faced relation with respect to said radiation detector for detecting radiation emitted by a tracer flowing in arteries into said forearm, the positioning guide comprising:
a forearm support surface for supporting said forearms from underneath;
and at least two abutment supports arranged substantially at opposed ends of said forearm in order to position said forearm in a substantially locked position, said supports being mounted with respect to said forearm support surface.
15. The apparatus as claimed in claim 14, further comprising a mounting for mounting said support guide to a surface of a 2-D gamma camera.
16. The apparatus as claimed in claim 13, 14 or 15, further comprising a holder for holding a bolus in a fixed position with respect to said detector for calibrating said bolus.
17. The apparatus as claimed in claim 12, wherein said means for holding comprises forearm positioning guides for aiding a patient to hold said forearms in a fixed position; and said detecting means comprise a radiation detector positioned with respect to said device to be in a substantially intermediary position of said forearms for detecting radiation emitted from a region of interest of said forearms.
18. The apparatus as claimed in claim 17, wherein a holder is provided for holding a bolus of a radioactive tracer in proximity to said detector for calibration.
19. The apparatus as claimed in claim 13, wherein said means for holding comprise:
a casing adapted to be substantially wrapped around said limb;
a closure for holding said casing securely around said limb;
said detecting means comprising:
a scintillation material provided on said casing; and a light detector optically coupled to said scintillation material for detecting scintillation fight and providing a detection output signal.
20. The apparatus as claimed in claim 19, wherein said scintillation material comprises one or more scintillation fibers.
21. Use of a tracer injected into a vein and detector means adapted for detecting and measuring presence of the tracer carried by blood flow into a limb and an an opposed, contra-lateral limb for obtaining data for the diagnosis of endothelial dysfunction following a release of a block of blood flow in one limb, wherein said limb blood flow is previously blocked for a period of time to stimulate endothelial function, and wherein said tracer injected into said vein is conducted to the heart and evenly distributed to said one limb and an opposed, contra-lateral limb via arteries.
22. The use as claimed in claim 21, wherein said measuring tracer presence comprises measuring tracer presence in both said limb and said contra-lateral limb, further comprising comparing tracer presence between both said limbs.
23. The use as claimed in claim 21 or 22, wherein said tracer comprises a radioactive tracer, said measuring comprises measuring radiation emitted from a region of interest in said limb.
24. The use as claimed in claim 23, further comprising measuring an activity of said bolus prior to injection to establish a reference activity level.
25. The use as claimed in claim 23 or 24, wherein said limbs comprise arms and said region of interest is a forearm.
26. The use as claimed in claim 25, wherein said forearms are placed palms down on a substantially flat surface in order to detect said region of interest of each one of said forearms.
27. The use as claimed in claim 26, wherein said radiation is measured as an image using a gamma camera on which said forearms are placed palms down.
28. The use as claimed in any one of claims 21 to 27, wherein said tracer presence is measured and recorded as a function of time.
29. The use as claimed in any one of claims 21 to 28, wherein said measuring comprises adjusting a position of said limbs with respect to a radiation detector so as to detect radiation with a substantially equal sensitivity for each of said limbs.
30. The use as claimed in any one of claims 21 to 29, wherein diagnosis of endothelial dysfunction is determined from a steady state measurement of said tracer presence.
CA2413352A 2000-06-26 2001-06-22 Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection Expired - Lifetime CA2413352C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/603,554 US6445945B1 (en) 2000-06-26 2000-06-26 Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection
US09/603,554 2000-06-26
PCT/CA2001/000935 WO2002000107A2 (en) 2000-06-26 2001-06-22 Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection

Publications (2)

Publication Number Publication Date
CA2413352A1 true CA2413352A1 (en) 2002-01-03
CA2413352C CA2413352C (en) 2012-09-04

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Family Applications (1)

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CA2413352A Expired - Lifetime CA2413352C (en) 2000-06-26 2001-06-22 Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection

Country Status (4)

Country Link
US (1) US6445945B1 (en)
AU (1) AU2001270393A1 (en)
CA (1) CA2413352C (en)
WO (1) WO2002000107A2 (en)

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Publication number Publication date
WO2002000107A3 (en) 2002-05-02
WO2002000107A2 (en) 2002-01-03
CA2413352C (en) 2012-09-04
US6445945B1 (en) 2002-09-03
AU2001270393A1 (en) 2002-01-08
WO2002000107B1 (en) 2002-07-25

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Effective date: 20210622