Neurological symptoms and gastrointestinal symptoms were rare at onset in COVID-19. Here we report a 37-year-old man with vertigo, fever, and diarrhea symptoms as the first manifestation. 18F-FDG PET/CT spotted multiple ground glass opacity (GGO) lesions in the lungs, with increased tracer uptake in both lung GGOs and the whole colon. Serial CT examinations showed the emersion and dissipation of lung GGOs. We illustrate the symptoms initiation, the laboratory test results, the imaging examination, and the treatment strategy in the duration of COVID-19 with a timeline chart.

This study aimed to examine the diagnosis performance of Tc-methoxyisobutylisonitrisonitrile (Tc-MIBI) and multimodality imaging [ultrasound, single-photon emission computed tomography/computed tomography (SPECT/CT)] for hyperparathyroidism (HPT). From Nov. 2009 to Dec. 2015, clinical data of a total of 43 HPT patients (16 males and 27 females; 26-70 years old, average age: 51.60±10.66 years old) were retrospectively analyzed. Among them, 19 patients with primary hyperparathyroidism (PHPT) underwent Tc-MIBI planar imaging, 24 [15 with PHPT and 9 with secondary hyperparathyroidism (SHPT)] underwent SPECT/CT hybrid imaging, and 41 (33 with PHPT and 8 with SHPT) had neck ultrasound imaging. Final diagnosis was determined by pathological examination after surgery. The positive rate was compared between different imaging modalities, and the correlation analysis was conducted between imaging results and lesion size or serum parathyroid hormone (PTH) level. The results showed that the total positive rates ofTc-MIBI imaging, ultrasound, and the two combined imaging in the 43 HPT cases were 90.70% (39/43), 58.54% (24/41), and 100% (41/41), respectively. According to lesion numbers, the positive rates were 79.10% (53/67), 53.23% (33/62), and 88.71% (55/62), respectively. SPECT/CT hybrid images were positive in all the 24 patients who underwent this examination. The mean maximum diameters of the lesions in Tc-MIBI positive and negative patients were 1.96±0.95 cm and 1.36±0.67 cm respectively, with statistically significant difference noted (P=0.03). The T/NT ofTc-MIBI imaging at the early phase was correlated positively with serum PTH level (r=0.40, P=0.01). The T/NT of Tc-MIBI imaging at both the early phase and the delay phase was correlated positively with lesion size (r=0.51, and r=0.45, respectively; P<0.01 for both). It was concluded that Tc-MIBI imaging presents significant value for location diagnosis of HPT, especially when combined with SPECT/CT hybrid imaging or ultrasound. TheTc-MIBI uptake correlates positively with serum PTH level and lesion size.

Background The molecular mechanisms of protective effect of metformin (Met) on ischemic myocardium have not been fully understood. This study aims to evaluate the cardioprotective effect of metformin on myocardial ischemia–reperfusion injury (MIRI) in rat models at different time points using dynamic 18F-FDG micro-PET/CT imaging. Methods The I/R injury model in SD rats was established by ligation of left anterior descending coronary artery near the pulmonary arch root for 30 min. SD rats (n = 12) were randomly divided into 2 groups: Control group (n = 6) without any intervention and Met group (n = 6) with oral administration of metformin (50 mg/kg) twice a day. Gated 18F-FDG (40Mbq) micro-PET/CT imaging was performed for 10 min at different time points (day 1st, day 7th, day 14th and day 30th after operation). Volumes of interest were drawn to identify different myocardium regions (ischemia center, peri-ischemia area and remote area). Standardized uptake values (SUVs) (SUVmean and SUVmax) were analyzed to evaluate the FDG uptake activity, and then the center/remote ratio was calculated. In addition, the left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV) and LV ejection fraction (LVEF) were obtained. On the 30th day, all rats were scarified and myocardial ischemia was analyzed by HE staining and confirmed by pathology. Results In the Control group, the center/remote ratio showed no obvious change trend at each time point after reperfusion, while the LV EDV increased gradually over time, and they were significantly negatively correlated (r = − 0.507, p < 0.05). In the Met group, the center/remote ratio gradually increased with time, there was no significant correlation between center/remote ratio and LV EDV (r = − 0.078, p > 0.05). On the 30th day, the center/remote ratio of the Met group was significantly higher than that of the Control group (0.81 ± 0.06 vs. 0.65 ± 0.09, p < 0.05), while LV EDV in Met group was significantly lower than in Control group (358.21 ± 22.62 vs. 457.53 ± 29.91, p < 0.05). There was no significant difference of LVEF between Met group and Control group at different time points after reperfusion (p < 0.05). HE staining showed that the myocardial infarction and fibrosis in ischemic center area of the Control group was more serious than that of the Met group. Conclusions Met could attenuate the severity of MIRI, delay and prevent the progress of LV remodeling. The cardioprotective progress could be dynamically assessed by 18F-FDG micro-PET/CT imaging.