Ядерная медицина в диагностике ангиопатий у пациентов с сахарным диабетом второго типа

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.