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Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 1. P. 56-64

DOI: 10.12737/25062

Nuclear Medicine in Diagnosis of Angiopathy in Patients with Diabetes Mellitus Type 2

D.S. Kharina1,2, T.A. Poletaeva1, A.K. Kondakov1,2, D. Yu. Mosin1, A.E. Nikitin1, I.A. Znamensky1,2

1. Central Clinical Hospital of RAS, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. N.I. Pirogov Russian National Research Medical University, Moscow, Russia

D.S. Kharina – radiologist in nuclear medicine department of Central Clinical Hospital of the RAS, post-graduate student in radiology and radiotherapy department, Pirogov Russian National Research Medical University (RNRMU); T.A. Poletaeva – head of therapeutic department of Central Clinical Hospital of the RAS; A.K. Kondakov – radiologist in nuclear medicine department of Central Clinical Hospital of the RAS, post-graduate student of radiology and radiotherapy department, Pirogov RNRMU; D.Yu. Mosin – radiologist in nuclear medicine department of Central Clinical Hospital of the RAS; A.E. Nikitin – head of Central Clinical Hospital of the RAS, MD., professor; I.A. Znamensky – head of nuclear medicine department of Central Clinical Hospital of the RAS, MD, professor of radiology and radiotherapy department, Pirogov RNRMU

Abstract

Purpose: To determine the role of nuclear medicine techniques in the early detection of angiopathy in patients with diabetes and to estimate their accuracy in comparison with routine diagnostic methods for evaluation of target organ damage.

Material and methods: A literature review, selected from the Russian and international bibliographic databases (RSCI, Medline, Google Scholar), dedicated to diagnostic technologies for identification of angiopathy in patients with diabetes mellitus.

Results: 193 sources dedicated to the diagnosis of micro- and macrovascular damage were analyzed, 66 of which were included in this study, 54 of them international and 12 domestic ones responding to the purpose of the study. The analysis revealed that the radionuclide methods of investigation reflecting the functional state of the tissues were evaluated in a small number of publications on early diagnosis angiopathy caused by diabetes mellitus type 2. Most often, high blood glucose concentration damages kidney tissue and myocardium. It is shown that the methods of dynamic nephroscintigraphy and ECG-gated myocardial perfusion SPECT allow to evaluate the progression of micro- and macrovascular disease before the manifestation of paraclinical signs according to other diagnostic methods. Key determined parameter in dynamic nephroscintigraphy is glomerular filtration rate, which declines on the early stages of the disease. Myocardial perfusion SPECT imaging provides a possibility to assess frequency and severity of ischemic myocardial injury.

Conclusions: The use of nuclear medicine techniques in the diagnosis of angiopathy in diabetes allows verification of early damage to target organs. The most effective diagnostic methods for this purpose are dynamic nephroscintigraphy and myocardial perfusion SPECT which sensitivity is substantially higher than conventional diagnostic methods.

Key words: diabetes mellitus type 2, nuclear medicine, dynamic nephroscintigraphy, myocardial perfusion imaging, impaired glucose tolerance

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For citation: Kharina DS, Poletaeva TA, Kondakov AK, Mosin DYu, Nikitin AE, Znamensky IA. Nuclear Medicine in Diagnosis of Angiopathy in Patients with Diabetes Mellitus Type 2. Medical Radiology and Radiation Safety. 2017;62(1):56-64. Russian. DOI: 10.12737/25062

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