基于门控99mTc-MIBI单光子发射计算机断层扫描定量左心室容积和射血分数：磁共振成像验证及埃默里心脏工具箱与QGS和4D-MSPECT的比较
Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT.
作者信息
Schaefer Wolfgang M, Lipke Claudia S A, Standke Dirk, Kühl Harald P, Nowak Bernd, Kaiser Hans-Juergen, Koch Karl-Christian, Buell Udalrich
机构信息
Department of Nuclear Medicine, University Hospital, Aachen University of Technology, Germany.
出版信息
J Nucl Med. 2005 Aug;46(8):1256-63.
UNLABELLED
The goal of this study was to validate the accuracy of the Emory Cardiac Tool Box (ECTB) in assessing left ventricular end-diastolic or end-systolic volume (EDV, ESV) and ejection fraction (LVEF) from gated (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) SPECT using cardiac MRI (cMRI) as a reference. Furthermore, software-specific characteristics of ECTB were analyzed in comparison with 4D-MSPECT and Quantitative Gated SPECT (QGS) results (all relative to cMRI).
METHODS
Seventy patients with suspected or known coronary artery disease were examined using gated (99m)Tc-MIBI SPECT (8 gates/cardiac cycle) 60 min after tracer injection at rest. EDV, ESV, and LVEF were calculated from gated (99m)Tc-MIBI SPECT using ECTB, 4D-MSPECT, and QGS. Directly before or after gated SPECT, cMRI (20 gates/cardiac cycle) was performed as a reference. EDV, ESV, and LVEF were calculated using Simpson's rule.
RESULTS
Correlation between results of gated (99m)Tc-MIBI SPECT and cMRI was high for EDV (R = 0.90 [ECTB], R = 0.88 [4D-MSPECT], R = 0.92 [QGS]), ESV (R = 0.94 [ECTB], R = 0.96 [4D-MSPECT], R = 0.96 [QGS]), and LVEF (R = 0.85 [ECTB], R = 0.87 [4D-MSPECT], R = 0.89 [QGS]). EDV (ECTB) did not differ significantly from cMRI, whereas 4D-MSPECT and QGS underestimated EDV significantly compared with cMRI (mean +/- SD: 131 +/- 43 mL [ECTB], 127 +/- 42 mL [4D-MSPECT], 120 +/- 38 mL [QGS], 137 +/- 36 mL [cMRI]). For ESV, only ECTB yielded values that were significantly lower than cMRI. For LVEF, ECTB and 4D-MSPECT values did not differ significantly from cMRI, whereas QGS values were significantly lower than cMRI (mean +/- SD: 62.7% +/- 13.7% [ECTB], 59.0% +/- 12.7% [4DM-SPECT], 53.2% +/- 11.5% [QGS], 60.6% +/- 13.9% [cMRI]).
CONCLUSION
EDV, ESV, and LVEF as determined by ECTB, 4D-MSPECT, and QGS from gated (99m)Tc-MIBI SPECT agree over a wide range of clinically relevant values with cMRI. Nevertheless, any algorithm-inherent over- or underestimation of volumes and LVEF should be accounted for and an interchangeable use of different software packages should be avoided.
未标注
本研究的目的是使用心脏磁共振成像（cMRI）作为参考，验证埃默里心脏工具箱（ECTB）在评估门控（99m）锝 - 甲氧基异丁基异腈（（99m）Tc - MIBI）单光子发射计算机断层扫描（SPECT）的左心室舒张末期或收缩末期容积（EDV、ESV）以及射血分数（LVEF）方面的准确性。此外，将ECTB的软件特定特征与4D - MSPECT和定量门控SPECT（QGS）的结果进行比较分析（均相对于cMRI）。
方法
70例疑似或已知冠状动脉疾病的患者在静息状态下注射示踪剂60分钟后接受门控（99m）Tc - MIBI SPECT检查（每个心动周期8个门控）。使用ECTB、4D - MSPECT和QGS从门控（99m）Tc - MIBI SPECT计算EDV、ESV和LVEF。在门控SPECT之前或之后，立即进行cMRI检查（每个心动周期20个门控）作为参考。使用辛普森法则计算EDV、ESV和LVEF。
结果
门控（99m）Tc - MIBI SPECT与cMRI在EDV（R = 0.90 [ECTB]，R = 0.88 [4D - MSPECT]，R = 0.92 [QGS]）、ESV（R = 0.94 [ECTB]，R = 0.96 [4D - MSPECT]，R = 0.96 [QGS]）和LVEF（R = 0.85 [ECTB]，R = 0.87 [4D - MSPECT]，R = 0.89 [QGS]）方面的相关性较高。EDV（ECTB）与cMRI无显著差异，而4D - MSPECT和QGS与cMRI相比显著低估了EDV（均值±标准差：ECTB为131±43 mL，4D - MSPECT为127±42 mL，QGS为120±38 mL，cMRI为137±36 mL）。对于ESV，只有ECTB得出的值显著低于cMRI。对于LVEF，ECTB和4D - MSPECT的值与cMRI无显著差异，而QGS的值显著低于cMRI（均值±标准差：ECTB为62.7%±13.7%，4D - MSPECT为59.0%±12.7%，QGS为53.2%±11.5%，cMRI为60.6%±13.9%）。
结论
由ECTB、4D - MSPECT和QGS从门控（99m）Tc - MIBI SPECT确定的EDV、ESV和LVEF在广泛的临床相关值范围内与cMRI一致。然而，应考虑任何算法固有的容积和LVEF高估或低估情况，并应避免不同软件包的互换使用。
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