Objective To evaluate the effects of metabolic factors on the quality of 18F-fluorode oxyglucose (18F-FDG) myocardial metabolic imaging in coronary artery disease (CAD) patients with type 2 diabetes mellitus (T2DM). Methods Seventy CAD patients aged 60 years or over with T2DM were studied with myocardial 18 F-FDG dual isotope simultaneous acquisition (DISA) single photon emission computed tomography (SPECT). Fasting plasma glucose, total triglyceride (TG),total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-eholesterol(LDL-C), insulin, C peptide and glyeosylated hemoglobia (HbAlc) were detected. Insulin resistance and islet β cell function were calculated by using the Homeostasis Model Assessment (HOMA) equation. Results Compared with the bad image quality group (36 cases), patients in the excellent image quality group (34 cases) were younger [with average age of (62.2±8.5) years vs. (67.6±8.3) years, P<0.01] and slimmer [with BMI of (24.7±2.6)kg/m2 vs. (26.1±2.5)kg/m2, P<0.05]. The levels of fasting insulin and C peptide were lower in the excellent image quality group than those in the bad image quality group [with fasting insulin level of 8.3 (5.1～12.4) mIu/L vs. 12.7,(6.1～17.9)mIu/L and C-peptide level of 0.6(0.5～0.9)nmol/L vs. 0.9(0.6～1.2)nmol/L, respectively,both P<0.05]. The HOMA insulin resistant index was reduced in the excellent image group [2.7(1.6～4.0) vs. 4.1(1.7～6.5), P<0.05]. Logistic regression analysis showed that obesity and age≥65 years were independent risk factors for image quality, with OR value of 3.73 (95% CI: 1.12～12.45,P=0.022)and 3.75 (95%CI:0.96～14.6,P=0.058)after adjustment of other metabolic factors. Conclusions Insulin resistance is the main factor that influences the quality of 18F-FDG myocardial metabolic imaging in patients with T2DM. In addition, age≥65 years and obesity are also risk factors for image quality.

Objective:To investigate the application value of renal depth correction by the integrated CT in glomerular filtration rate (GFR) determination by 99Tc m-diethylene triamine pentoacetic acid (DTPA) renal dynamic imaging for patients with hydronephrosis. Methods:A total of 338 patients (191 males, 147 females, age (49.6±14.5) years) in Beijing Tsinghua Changgung Hospital from April 2016 to June 2019 with different degrees of hydronephrosis were respectively analyzed. Patients were divided into groups of normal-mild, normal-moderate, normal-heavy, mild-mild, mild-moderate, mild-heavy, moderate-moderate, moderate-heavy and heavy-heavy according to the degree of bilateral hydronephrosis. The renal depth was measured by the integrated CT method and the routine method, and the absolute value of bilateral renal depth difference in normal-mild, normal-moderate and normal-heavy groups was calculated by the 2 methods. Based on the renal depth measured by the 2 methods, the single renal GFR was measured by 99Tc m-DTPA dynamic renal imaging Gates method and compared between the 2 methods. Total GFR measured by the 2 methods were compared with estimated GFR (eGFR). One-way analysis of variance analysis, paired t test, and Pearson correlation analysis were used. Results:For the integrated CT measurements, the absolute value of bilateral renal depth difference in normal-mild, normal-moderate and normal-heavy groups were significantly different ((0.39±0.24), (1.16±0.65) and (1.00±0.90) cm; F=15.241, P<0.05). The renal depth and the single renal GFR measured by the integrated CT method were higher than those measured by the routine method ( t values: 16.06-19.78, 14.27-17.23, all P<0.05) in the kidneys with normal, mild, moderate and heavy hydronephrosis. There were significant differences between the total GFR measured by the routine method and eGFR in all groups ( t values: from -8.178 to 5.879, all P<0.05); however, in the integrated CT method, except that the total GFRs in moderate-heavy group and heavy-heavy group were overestimated ( t values: 3.035 and 11.247, both P<0.05), there were no significant differences between the total GFR ((111.57±17.37), (103.71±15.22), (79.79±12.62), (100.33±18.49), (100.28±15.43), (84.09±20.72) and (74.14±14.57) ml·min -1·1.73 m -2) and eGFR ((109.16±12.81), (103.20±13.26), (78.60±14.12), (100.98±15.20), (99.89±14.05), (84.61±20.24) and (73.44±14.57) ml·min -1·1.73 m -2) in normal-mild, normal-moderate, normal-heavy, mild-mild, mild-moderate, mild-heavy and moderate-moderate groups ( t values: from -0.301 to 1.948, all P>0.05). The total GFR measured by the 2 methods were significantly correlated with eGFR in 338 patients with hydronephrosis ( r values: 0.888 and 0.928, both P<0.01). Conclusion:Compared with the routine method, except for the moderate-heavy group and heavy-heavy group, renal depth correction by the integrated CT may have greater clinical significance in GFR measurement by renal dynamic imaging for patients with hydronephrosis.

Humans ; Incretins/therapeutic use* ; Diabetes Mellitus, Type 2/drug therapy* ; Hypoglycemic Agents/therapeutic use* ; Risk Assessment