123I-MIBG myocardial scintigraphy in diabetic patients: relationship to autonomic neuropathy.
The aim of this study was to investigate the relationship between autonomic nerve dysfunction and myocardial uptake of 123I-meta-iodobenzyl guanidine (MIBG) in patients with diabetes mellitus. Twenty-two non-insulin-dependent diabetic patients, 9 with autonomic neuropathy [ANP(+)] and 13 without autonomic neuropathy [ANP(-)], and 8 controls were included in the study. Both planar and single photon emission tomographic (SPET) images were obtained 30 min (early) and 3 h (delayed) after the 123I-MIBG injection. The heart-to-mediastinal uptake ratio (H/M) and the washout ratio of 123I-MIBG (%WR) were calculated from planar images. The uptake ratio of the inferior wall to the anterior wall (I/ A) and the %WR of both the inferior and anterior walls were calculated from the SPET images. On the early plantar images, the mean H/M ratio in the ANP(+) group was significantly lower than that of the control group. The mean %WR on the planar images in the ANP(-) group was significantly higher than that of the controls. The SPET images demonstrated a reduction in MIBG uptake and significantly increased clearance in the inferior wall of the ANP(-) patients. These findings extended to other areas of the heart in the ANP(+) patients. In the quantitative analysis of the SPET images, the ANP(+) group had significantly lower I/A values and significantly higher %WR values in the anterior wall. The ANP(+) group showed significantly increased clearance of 123I-MIBG in the inferior wall. We conclude that 123I-MIBG myocardial scintigraphy is a useful diagnostic tool both in the early detection and evaluation of the progression of myocardial sympathetic nerve dysfunction in patients with diabetes mellitus. Both the I/A and %WR calculated from SPET images are useful parameters.
Nagamachi
S
S
Department of Radiology, Miyazaki Medical College, Japan.
Jinnouchi
S
S
Nakahara
H
H
Flores
L G
LG
Ohnishi
T
T
Hoshi
H
H
Futami
S
S
Watanabe
K
K
Nakatsuru
K
K
Toshimori
T
T
Matsukura
S
S
D019797:3-Iodobenzylguanidine; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging*; D003929:Diabetic Neuropathies / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019797:3-Iodobenzylguanidine