门控心血池断层扫描术用于评估左心室整体和局部功能，并与平面技术及超声心动图进行比较。

Gated blood pool tomography for the evaluation of global and regional left ventricular function in comparison to planar techniques and echocardiography.

作者信息

Canclini S, Terzi A, Rossini P, Vignati A, La Canna G, Magri G C, Pizzocaro C, Giubbini R

机构信息

Division of Nuclear Medicine, Spedali Civili, Brescia, Italy.

出版信息

Ital Heart J. 2001 Jan;2(1):42-8.

PMID:11214701

Abstract

BACKGROUND

Multigated radionuclide ventriculography (MUGA) is a simple and reliable tool for the assessment of global systolic and diastolic function and in several studies it is still considered a standard for the assessment of left ventricular ejection fraction. However the evaluation of regional wall motion by MUGA is critical due to two-dimensional imaging and its clinical use is progressively declining in favor of echocardiography. Tomographic MUGA (T-MUGA) is not widely adopted in clinical practice. The aim of this study was to compare T-MUGA to planar MUGA (P-MUGA) for the assessment of global ejection fraction and to transthoracic echocardiography for the evaluation of regional wall motion.

METHODS

A 16-segment model was adopted for the comparison with echo regional wall motion. For each one of the 16 segments the normal range of T-MUGA ejection fraction was quantified and a normal data file was defined; the average value -2.5 SD was used as the lower threshold to identify abnormal segments. In addition, amplitude images from Fourier analysis were quantified and considered abnormal according to three different thresholds (25, 50 and 75% of the maximum).

RESULTS

In a study group of 33 consecutive patients the ejection fraction values of T-MUGA highly correlated with those of P-MUGA (r = 0.93). The regional ejection fraction (according to the normal database) and the amplitude analysis (50% threshold) allowed for the correct identification of 203/226 and 167/226 asynergic segments by echocardiography, and of 269/302 and 244/302 normal segments, respectively. Therefore sensitivity, specificity and overall accuracy to detect regional wall motion abnormalities were 90, 89, 89% and 74, 81, 79% for regional ejection fraction and amplitude analysis, respectively.

CONCLUSIONS

T-MUGA is a reliable tool for regional wall motion evaluation, well correlated with echocardiography, less subjective and able to provide quantitative data.

摘要

背景

多门控放射性核素心室造影（MUGA）是评估整体收缩和舒张功能的一种简单可靠的工具，在多项研究中它仍被视为评估左心室射血分数的标准。然而，由于其二维成像，MUGA对局部室壁运动的评估存在局限性，其临床应用正逐渐减少，而更倾向于超声心动图检查。断层MUGA（T-MUGA）在临床实践中未被广泛采用。本研究的目的是比较T-MUGA与平面MUGA（P-MUGA）在评估整体射血分数方面的差异，并与经胸超声心动图在评估局部室壁运动方面进行比较。

方法

采用16节段模型与超声心动图的局部室壁运动进行比较。对于16个节段中的每一个，量化T-MUGA射血分数的正常范围并定义一个正常数据文件；使用平均值减去2.5个标准差作为识别异常节段的下限阈值。此外，对傅里叶分析得到的振幅图像进行量化，并根据三个不同的阈值（最大值的25%、50%和75%）判断为异常。

结果

在一个连续纳入33例患者的研究组中，T-MUGA的射血分数值与P-MUGA的射血分数值高度相关（r = 0.93）。根据正常数据库的局部射血分数和振幅分析（50%阈值）分别能够正确识别超声心动图检查显示的203/226和167/226个运动不协调节段，以及269/302和244/302个正常节段。因此，检测局部室壁运动异常的敏感性、特异性和总体准确性，局部射血分数分别为90%、89%、89%，振幅分析分别为74%、81%、79%。