Nakata T, Katagiri Y, Odawara Y, Eguchi M, Kuroda M, Tsuchihashi K, Hareyama M, Shimamoto K
Second Department of Internal Medicine, Cardiology, Sapporo Medical University School of Medicine, Japan.
J Nucl Cardiol. 2000 Nov-Dec;7(6):623-32. doi: 10.1067/mnc.2000.109271.
Although the myocardial gated single photon emission computed tomography (SPECT) technique makes it possible to assess concurrent myocardial perfusion and function, quantitative methods for analyzing and displaying gated SPECT data in 2- and 3-dimensional presentations for regional and global cardiac assessment have not been established.
We have developed an automated quantitative method for assessing perfusion and function by means of technetium-99m sestamibi gated SPECT with a computerized technique combining count-based and image-based methods. We have examined its validity in 91 patients by comparing its results with those of conventional techniques: contrast left ventriculography and radionuclide angiocardiography. In addition to color-scale displays of regional function, simultaneous 3-dimensional presentations of regional wall motion and perfusion have been produced. High reproducibility of gated SPECT analysis with this algorithm was demonstrated; interoperator errors (%CV) were 2.6% to 5.5%, and good intraobserver reproducibility was confirmed by means of high correlation coefficients (0.954 to 0.989). Left ventricular volumes assessed by means of contrast left ventriculography and by means of the gated SPECT technique showed significant correlations (left ventricular end-diastolic volume, y = 1.01x - 9.7, r = 0.845, P<.001, standard errors of the estimate [SEE] = 14 mL; left ventricular end-systolic volume, y = 1.03x - 1.4, r = 0.902, P<.001, SEE = 6 mL). Left ventricular ejection fraction determined by means of gated SPECT with the new algorithm closely correlated with that determined by means of radionuclide ventriculography (y = 1.05x - 0.6, r = 0.891, P<.001, SEE = 3 %). These parameters quantified by means of the present method correlated closely with those derived from the QGS program (r = 0.926 to 0.987).
In comparison with conventional techniques, myocardial gated SPECT with automated quantitative analysis provides accurate and reproducible data for global and regional function. Quantitative concurrent assessment of myocardial perfusion and function by using 2-and 3-dimensional representations appears to be superior to other modalities and to contribute to nuclear cardiology practice.
尽管心肌门控单光子发射计算机断层扫描（SPECT）技术使同时评估心肌灌注和功能成为可能，但尚未建立用于在二维和三维呈现中分析和显示门控SPECT数据以进行区域和整体心脏评估的定量方法。
我们开发了一种自动定量方法，通过锝-99m 甲氧基异丁基异腈门控SPECT，并结合基于计数和基于图像的方法的计算机技术来评估灌注和功能。我们通过将其结果与传统技术（对比剂左心室造影和放射性核素心血管造影）的结果进行比较，在91例患者中检验了其有效性。除了区域功能的彩色标度显示外，还生成了区域壁运动和灌注的同步三维呈现。使用该算法的门控SPECT分析具有高重现性；不同操作者间的误差（%CV）为2.6%至5.5%，并且通过高相关系数（0.954至0.989）证实了良好的观察者内重现性。通过对比剂左心室造影和门控SPECT技术评估的左心室容积显示出显著相关性（左心室舒张末期容积，y = 1.01x - 9.7，r = 0.845，P <.001，估计标准误差[SEE] = 14 mL；左心室收缩末期容积，y = 1.03x - 1.4，r = 0.902，P <.001，SEE = 6 mL）。使用新算法通过门控SPECT确定的左心室射血分数与通过放射性核素心室造影确定的左心室射血分数密切相关（y = 1.05x - 0.6，r = 0.891，P <.001，SEE = 3%）。通过本方法量化的这些参数与从QGS程序得出的参数密切相关（r = 0.926至0.987）。
与传统技术相比，具有自动定量分析的心肌门控SPECT可为整体和区域功能提供准确且可重现的数据。使用二维和三维表示对心肌灌注和功能进行定量同时评估似乎优于其他方法，并有助于核心脏病学实践。
