门控99mTc-司他米比单光子发射计算机断层显像期间患者俯卧位与仰卧位的体位：对左心室容积、射血分数和心率的影响

Prone versus supine patient positioning during gated 99mTc-sestamibi SPECT: effect on left ventricular volumes, ejection fraction, and heart rate.

作者信息

Schaefer Wolfgang M, Lipke Claudia S A, Kühl Harald P, Koch Karl-Christian, Kaiser Hans-Juergen, Reinartz Patrick, Nowak Bernd, Buell Udalrich

机构信息

Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany.

出版信息

J Nucl Med. 2004 Dec;45(12):2016-20.

PMID:15585475

Abstract

UNLABELLED

Gated myocardial perfusion SPECT allows assessment of left ventricular end-diastolic volume (EDV), left ventricular end-systolic volume (ESV), left ventricular stroke volume (SV), and left ventricular ejection fraction (LVEF). Acquiring images with the patient both prone and supine is an approved method of identifying and reducing artifacts. Yet prone positioning alters physiologic conditions. This study investigated how prone versus supine patient positioning during gated SPECT affects EDV, ESV, SV, LVEF, and heart rate.

METHODS

Forty-eight patients scheduled for routine myocardial perfusion imaging were examined with gated (99m)Tc-sestamibi SPECT (at rest) while positioned prone and supine (consecutively, in random order). All parameters for both acquisitions were calculated using the commercially available QGS algorithm.

RESULTS

Whereas EDV and SV were significantly lower (P < 0.0004) for prone acquisitions (EDV, 110.5 +/- 39.1 mL; SV, 55.9 +/- 13.3 mL) than for supine acquisitions (EDV, 116.9 +/- 36.2 mL; SV, 61.0 +/- 14.5 mL), ESV and LVEF did not differ significantly. Heart rate was significantly higher (P < 0.0001) during prone acquisitions (69.1 +/- 10.5 min(-1)) than during supine acquisitions (66.5 +/- 10.0 min(-1)).

CONCLUSION

The observed position-dependent effect on EDV, SV, and heart rate might be explained by decreased arterial filling and increased sympathetic nerve activity. Hence, supine reference data should not be used to classify the results of prone acquisitions.

摘要

未标注

门控心肌灌注单光子发射计算机断层扫描（SPECT）可用于评估左心室舒张末期容积（EDV）、左心室收缩末期容积（ESV）、左心室每搏输出量（SV）和左心室射血分数（LVEF）。让患者俯卧位和仰卧位采集图像是一种已获批准的识别和减少伪影的方法。然而，俯卧位会改变生理状况。本研究调查了门控SPECT检查期间患者俯卧位与仰卧位对EDV、ESV、SV、LVEF和心率的影响。

方法

48例计划进行常规心肌灌注成像的患者在俯卧位和仰卧位（按随机顺序连续进行）时接受门控（99m）锝-甲氧基异丁基异腈SPECT（静息状态下）检查。两次采集的所有参数均使用市售的QGS算法进行计算。

结果

俯卧位采集时的EDV和SV显著低于仰卧位采集（P < 0.0004）（EDV，110.5±39.1 mL；SV，55.9±13.3 mL），而仰卧位采集时EDV为116.9±36.2 mL，SV为61.0±14.5 mL），ESV和LVEF无显著差异。俯卧位采集时的心率显著高于仰卧位采集时（P < 0.0001）（分别为69.1±10.5次/分钟和66.5±10.0次/分钟）。