Daou Doumit, Vilain Didier, Colin Patrice, Lebtahi Rachida, Fourme Thierry, Coaguila Carlos, Benada Abdel, Idy-Peretti Ilana, Slama Michel, Le Guludec Dominique
Department of Nuclear Medicine, Lariboisière University Hospital, AP-HP, Paris, France.
Eur J Nucl Med Mol Imaging. 2003 Jun;30(6):859-67. doi: 10.1007/s00259-003-1121-5. Epub 2003 Apr 4.
Both electrocardiographically (ECG) gated blood pool SPET (GBPS) and ECG-gated myocardial perfusion SPET (GSPET) are currently used for the measurement of global systolic left ventricular (LV) function. In this study, we aimed to compare the value of GSPET and GBPS for this purpose. The population included 65 patients who underwent rest thallium-201 GSPET imaging at 15 min after (201)Tl injection followed by planar (planar(RNA)) and GBPS equilibrium radionuclide angiography immediately after 4-h redistribution myocardial perfusion SPET imaging. Thirty-five patients also underwent LV conventional contrast angiography (X-rays). LV ejection fraction (EF) and LV volume [end-diastolic (EDV) and end-systolic (ESV) volumes] were calculated with GBPS and GSPET and compared with the gold standard methods (planar(RNA) LVEF and X-ray based calculation of LV volume). For both LVEF and LV volume, the inter-observer variability was lower with GBPS than with GSPET. GBPS LVEF was higher than planar(RNA) (P<0.01) and GSPET LVEF (P<0.01). Planar(RNA) LVEF showed a slightly better correlation with GBPS LVEF than with GSPET LVEF: r=0.87 and r=0.83 respectively. GSPET LV volume was lower than that obtained using X-rays and GBPS (P<0.01 for both). LV volume calculated using X-rays showed a slightly better correlation with GBPS LV volume than with GSPET LV volume: r=0.88 and r=0.83 respectively. On stepwise regression analysis, the accuracy of GSPET for the measurement of LVEF and LV volume was correlated with a number of factors, including planar(RNA) LVEF, signal to noise ratio, LV volume calculated using X-rays, summed rest score and acquisition scan distance (i.e. the radius of rotation). The accuracy of GBPS for the measurement of LVEF and LV volume was correlated only with the signal level, the signal to noise ratio and the acquisition scan distance. Both GSPET and GBPS provide reliable estimation of global systolic LV function. The better reliability of GBPS and in particular its lower sensitivity to different variables as compared with GSPET favours its use when precise assessment of global systolic LV function is clinically indicated.
心电图（ECG）门控心血池单光子发射计算机断层显像（GBPS）和ECG门控心肌灌注单光子发射计算机断层显像（GSPET）目前均用于测量左心室（LV）整体收缩功能。在本研究中，我们旨在比较GSPET和GBPS在此方面的价值。研究人群包括65例患者，他们在注射铊-201后15分钟接受静息铊-201 GSPET显像，随后在4小时再分布心肌灌注SPET显像后立即进行平面显像（平面（RNA））和GBPS平衡放射性核素血管造影。35例患者还接受了LV传统对比血管造影（X线）。用GBPS和GSPET计算LV射血分数（EF）和LV容积[舒张末期（EDV）和收缩末期（ESV）容积]，并与金标准方法（平面（RNA）LVEF和基于X线计算的LV容积）进行比较。对于LVEF和LV容积，GBPS的观察者间变异性均低于GSPET。GBPS LVEF高于平面（RNA）（P<0.01）和GSPET LVEF（P<0.01）。平面（RNA）LVEF与GBPS LVEF的相关性略优于与GSPET LVEF的相关性：分别为r=0.87和r=0.83。GSPET LV容积低于用X线和GBPS获得的LV容积（两者均P<0.01）。用X线计算的LV容积与GBPS LV容积的相关性略优于与GSPET LV容积的相关性：分别为r=0.88和r=0.83。在逐步回归分析中，GSPET测量LVEF和LV容积的准确性与多个因素相关，包括平面（RNA）LVEF、信噪比、用X线计算的LV容积、静息总分和采集扫描距离（即旋转半径）。GBPS测量LVEF和LV容积的准确性仅与信号水平、信噪比和采集扫描距离相关。GSPET和GBPS均能可靠地估计LV整体收缩功能。与GSPET相比，GBPS具有更好的可靠性，尤其是其对不同变量的敏感性较低，因此在临床需要精确评估LV整体收缩功能时更适合使用。
