|
|
Effect of early blood glucose regulation on myocardial metabolism imaging quality of 18F-FDG PET in patients with coronary heart disease |
YIN Liang, YUE Jianlan, HUANG Shiming, ZHANG Qing, LIU Fei, WANG Qiuju, LIN Zhichun |
Department of Nuclear Medicine, Characteristic Medical Center of Chinese People's Armed Police Force, 300162 Tianjin, China |
|
|
Abstract Objective To investigate the effect of early blood glucose regulation on myocardial metabolism imaging quality of 18F-FDG PET/CT patients with CHD.Methods One hundred and thirty-one patients with CHD and aged 61.1±9.3 (33~79) years (121 males and 10 females, including 68 patients with DM and 63 patients without DM) were enrolled. Fasting oral glucose + intravenous insulin was administered to regulate blood glucose. Fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose during injection(BGinjection), high glucose and insulin dosage were measured before 18F-FDG PET myocardial metabolism imaging was performed. The image quality was assessedusing the blind scoring method.Results Imaging failed in only one case among the 131 patients, so the success rate of imaging was 99.2%.Analysis of the 130 successful imaging patients with or without diabetes showed that non-diabetic patients were more likely to obtain better-quality images(P=0.002). FBG and BGinjection had an impact on image quality. Patients with low FBG and BGinjection were more likely to obtain high-quality images, and the difference was statistically significant (Both P=0.000), while PBG and the deviation value of blood glucose (BGdeviation)had no significant impact on final image quality (P=0.191 and 0.283, respectively). There was no significant correlation between the insulin/glucose ratio and image quality in the non-diabetic group (P=0.484), but the insulin/glucose ratio in the non-diabetic group was different between groups ofdifferent image quality.The insulin/glucose ratio in the better image quality group (score 3) was higher, with statistically significant difference (P=0.021). Conclusions The success rate of 18F-FDG PET myocardial metabolism imaging is high with oral glucose + intravenous insulin. The main factors that affectimage quality are FBG and BGinjection. Patients with diabetes need to use higher doses of insulin and lower doses of glucose.
|
Received: 17 August 2020
|
|
|
|
|
[1] |
Dilsizian V, Bacharach SL, Beanlands RS, et al. ASNC imaging guidelines/SNMMI procedure standard for positron emission tomography (PET) nuclear cardiology procedures[J].J NuclCardiol,2016,23(5): 1187-1226.
|
[2] |
朱紫薇, 常 智, 史晓鹏, 等. 合并和不合并糖尿病的冠心病患者18F-FDG PET/CT心肌代谢图像质量及其影响因素[J]. 中华核医学与分子影像杂志, 2020, 40(5): 81-286.
|
[3] |
王海宁, 方 纬, 刘 辰, 等. 2型糖尿病患者氟-18标记脱氧葡萄糖心肌代谢显像图像质量与相关代谢因素的分析[J]. 中华老年医学杂志, 2009, 28(1): 11-14.
|
[4] |
Partington S L, Kwong R Y, Dorbala S. Multimodality imaging in the assessment of myocardial viability[J].Heart Fail Rev,2011,16(4): 381-395.
|
[5] |
邸丽娟,王荣福. 核素心血管显像在冠心病诊断中的应用及进展[J]. 中华临床医师杂志(电子版), 2010, 4(10): 1910-1913.
|
[6] |
Bax J J, Visser F C, Raymakers P G, et al. Cardiac 18F-FDG-SPET studies in patients with non-insulin-dependent diabetes mellitus during hyperinsulinaemiceuglycaemic clamping[J].Nucl Med Commun,1997, 18(3): 200-206.
|
[7] |
Schinkel A F, Bax J J, Valkema R, et al. Effect of diabetes mellitus on myocardial 18F-FDG SPECT using acipimox for the assessment of myocardial viability[J].J Nucl Med,2003, 44(6):877-883.
|
[8] |
Chong C R, Clarke K, Levelt E. Metabolic Remodeling in Diabetic Cardiomyopathy[J].Cardiovasc Res,2017, 113(4): 422-430.
|
[9] |
贾志新, 王全师, 吴湖炳. 18F-FDG PET显像评价血糖水平对心肌葡萄糖代谢的影响[J]. 中国临床医学影像杂志, 2003, 14(6): 445-446.
|
[10] |
Coort S L, Bonen A, Vusse G J, et al. Cardiac substrate uptake and metabolism in obesity and type-2 diabetes: role of sarcolemmal substrate transporters[J].Mol Cell Biochem,2007, 299(1-2): 5-18.
|
[11] |
刘建文, 耿亚琴. 糖负荷联合皮下注射胰岛素法在双核素心肌代谢显像血糖调控中的应用[J]. 护理研究, 2015, 29(7A): 2414-2416.
|
[12] |
吴锐先, 王治国, 郭 佳, 等. 不同血糖调节方法对18F-氟脱氧葡萄糖正电子发射计算机断层成像心肌代谢显像影响[J]. 临床军医杂志, 2018, 46(11): 1282-1284.
|
[13] |
Demeure F, Hanin F X, Bol A, et al. A randomized trial on the optimization of 18F-FDG myocardial uptake suppression: implications for vulnerable coronary plaque imaging[J].J Nucl Med,2014, 55(10): 1629-1635.
|
[14] |
刘晓洁, 褚 俊, 杨 扬, 等. 18氟标记脱氧葡萄糖心肌正电子发射型计算机断层扫描显像仪心肌代谢显像检查的方法学研究[J]. 中国临床保健杂志, 2011, 14(2): 132-134.
|
[15] |
李 婷, 李剑明, 卢如明. 静脉糖负荷联合胰岛素法调控血糖在猪18F-FDG PET/CT心肌显像中的应用[J]. 中国医学影像技术, 2018, 34(9): 1323-1327.
|
[16] |
科雨彤, 田丛娜, 魏红星, 等. 门控心肌灌注和心肌代谢显像动态评价小型猪室壁瘤形成后左心室功能和重构变化的实验研究[J]. 中国循环杂志, 2015, 30(6): 580-584.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(9): 819-822. |
|
|
|
|