Semra Ozdemir

Evaluation of liver perfusion in diabetic patients using 99mTc-sestamibi

SummaryObjectiveThe liver is an important organ for various aspects of glucose metabolism, including glucose uptake, storage, and synthesis. It is a major organ in the metabolic process with perfusion provided by both the portal vein and hepatic artery. In diabetic patients organ perfusion is reduced and this is linked to atherosclerosis, and as a result complications occur. In this study, we aimed to evaluate liver perfusion by scintigraphic methods in diabetic patients.Design and patientsWe retrospectively investigated 1,100 myocardial perfusion scintigraphies taken between January 2011 and December 2012 at Canakkale Onsekiz Mart University Medical Faculty Nuclear Medicine Department. A total of 66 patients who were diagnosed with diabetes mellitus and had myocardial perfusion scintigraphies were included in the study. The control subjects included 127 patients without diabetes mellitus who were chosen at random. Patients with chronic liver disease were not included in the study. The values from liver regions of interest (liver-ROI) rates and heart regions of interest (heart-ROI) rates were compared between the patients and controls.ResultsPatients were grouped according to the presence of diabetes. In the diabetes mellitus group, the liver-ROI average was lower (p = 0.66) than in the controls. In the control group, the average liver-ROI/heart-ROI ratios were higher than the ratio in the diabetes mellitus group (p = 0.019). Multivariate variance analysis showed that the diabetes mellitus liver-ROI/heart-ROI ratio was independent of other risk factors (p = 0.003; F: 9.6). Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation.ConclusionsThis study shows that liver perfusion in diabetic patients is reduced compared with those without diabetes. Prospective studies with larger patient groups are required.ZusammenfassungZielDie Leber ist aus verschiedenen Gründen (Glukose-Aufnahme, -Speicherung, -Synthese) für den Glu-kosestoffwechsel wichtig. Sie ist ein wesentliches Organ des Stoffwechselprozesses, wobei die Perfusion sowohl durch die Vena portae, als auch durch die Arteria hepatica erfolgt. Bei Diabetikern ist ihre Perfusion als Folge der Atherosklerose vermindert. Dadurch können Komplikationen auftreten. In der vorliegenden Studie war es unser Ziel, bei Diabetikern die Perfusion der Leber mit szintigraphischen Methoden zu erheben.Design der Studie und PatientenWir untersuchten retrospektiv 1100 Myokard-Perfusions-Szintigraphien, die zwischen Januar 2011 und Dezember 2012 an der Abteilung für Nuklearmedizin der Canakkale Onsekiz Mart Universität, Fakultät für Medizin, durchgeführt worden waren. In die Studie wurden 66 Patienten mit der Diagnose Diabetes mellitus, bei denen eine Myokardszintigraphie durchgeführt worden war, aufgenommen. Die Kontrollpersonen bestanden aus 127 zufällig ausgewählten Patienten ohne Diabetes mellitus. Patienten mit chronischer Lebererkrankung wurden in die Studie nicht aufgenommen. Die Werte der bei den Patienten erhobenen Leberregionen von Interesse (Leber – „Regions of Interest“ – ROI), sowie der Herz ROI wurden mit den bei den Kontrollpersonen erhobenen Werten verglichen.ErgebnisseDie Patienten wurden entsprechend dem Vorliegen von Diabetes gruppiert. In der Gruppe mit Diabetes mellitus war die Leber ROI niedriger (p = 0,66) als bei den Kontrollen. Bei der Kontrollgruppe waren die Mittelwerte der Leber ROI/Herz ROI Quotienten höher als bei der Diabetes mellitus Gruppe (p = 0,019). Die Multivarianzanalyse ergab, dass bei den Diabetikern die Leber ROI/Herz ROI Quotienten unabhängig von anderen Risikofaktoren waren (p = 0,003; F: 9,6).SchlussfolgerungenDiese Studie zeigt, dass die Leberperfusion bei Patienten mit Diabetes mellitus im Vergleich zur Leberperfusion bei Patienten ohne Diabetes mellitus vermindert ist. Prospektive Studien mit größeren Patientengruppen sind allerdings zur Bestätigung nötig.

Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia. Conflict of interest:None declared.

Is the increased septal perfusion the signal of asymmetrical septal hypertrophy

In this study, we have compared scintigraphic and echocardiographic data in order to investigate whether increased septal perfusion represents asymmetrical septal hypertrophy (ASH), which is a symptom followed in the scintigraphy of myocardial perfusion. The study consists of a total of 186 patients (120 females and 66 males with an average age of 59.45 ± 11.54 years) who had normal myocardial perfusion scintigraphy and echocardiography examinations. Statistical comparison of septal wall thickness measurements obtained from echocardiography and septal-to-lateral wall ratios (S/L ratio) was performed scintigraphically. Left ventricular mass values were obtained as both scintigraphic and echocardiographic data and their correlations were evaluated in order to assess the presence of left ventricular hypertrophy (LVH). In statistical analyses, the values of interventricular septal thickness in diastole (IVSd), left ventricle posterior wall thickness in diastole (LVPWd), left ventricle mass (LVM), and left ventricle mass index (LVMI) were found to be significantly higher in group 2 (S/L ratio >1) compared to group 1 (S/L ratio <1). In addition, S/L ratio is significantly correlated with echocardiographic IVSd, LVPWd, LVM, LVMI, and scintigraphic LVM (rest) values. Furthermore, echocardiographic LVM and LVMI values were significantly correlated with LVM and LVMI values obtained from scintigraphy. It should be known that increased S/L ratio that can be monitored during scintigraphic studies can be an indicator of septal hypertrophy and/or LVH, however, further examination and close follow-ups should be performed in necessary cases.

Risk stratification using gated stress myocardial perfusion imaging: comparison between patients with and without sexual dysfunction.

Sexuality is an indispensable part of life. When a problem is encountered related to this topic, the quality of life is negatively affected. Therefore, every problem related to sexuality is extremely private and important to an individual. This study aims to investigate the use of myocardial perfusion scintigraphy (MPS) for advanced assessment of patients with known or suspected coronary artery disease, cardiovascular disease, and in the intermediate risk group for SD. The study included 250 patients (150 male, 100 female, mean age 54±12.10) sent by the Cardiology Clinic to the Nuclear Medicine Clinic for MPS due to suspected cardiovascular disease (CVD). The questionnaire study was applied by two methods as face-to-face interviews or online. Data on sociodemographic characteristics and cardiovascular diseases together with risk factors for sexual activity were collected using a general information form. Patients were divided into three categories of risk depending on major risk factors for cardiovascular diseases: low, intermediate, and high risk. On comparing the risk scores between the groups, it was seen that there was a statistically clear reduction in the intermediate risk group of patients with SD according to MPS scoring. MPS is a cost-effective, reliable, and accurate non-invasive diagnostic method necessary for routine use to assess cardiovascular disease and in the intermediate risk group for SD.

The Relationship Between Some Complete Blood Count Parameters and Myocardial Perfusion: A Scintigraphic Approach.

Recent studies have shown that there is a relationship between some inflammatory and biochemical markers derived from complete blood count (CBC) such as neutrophil/lymphocyte (N/L) ratio, platelet/lymphocyte (P/L) ratio, platelet distribution width (PDW), red blood cell distribution width (RDW), and coronary artery disease (CAD). The aim of this study was to determine N/L ratio, P/L ratio, PDW values, and RDW values, which are associated with myocardial perfusion in patients diagnosed with CAD. This study included 262 patients (149 with myocardial ischemia/infarction and 113 with normal myocardial perfusion) undergoing myocardial perfusion scintigraphy (MPS) with CBC within 90 days of MPS. Myocardial perfusion parameters such as summed stress score and summed difference score (SDS) were compared with N/L ratio, P/L ratio, PDW values, and RDW values. Neutrophil counts and N/L ratios were significantly higher in patients diagnosed with myocardial ischemia and/or infarct. However, there was no statistically significant relationship between myocardial perfusion abnormalities and P/L ratio, PDW values, and RDW values. This study showed that N/L ratio is related to myocardial ischemia/infarction and correlated to left ventricular ejection fraction (LVEF).