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NAGAMACHI S.; JINNOUCHI, S.; NAKAHARA, H.; FLORES, L. G. II; OHNISHI, T.; HOSHI, H.; FUTAMI, S.; WATANABE, K.; NAKATSURU, K.; TOSHIMORI, T.; MATSUKURA, S.
Nuclear Medicine Communications: July 1996
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Summary

The aim of this study was to investigate the relationship between autonomic nerve dysfunction and myocardial uptake of l23I-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 planar 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.

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