Daou Doumit, Coaguila Carlos, Benada Abdel
Department of Nuclear Medicine, Lariboisière University Hospital, AP-HP, Paris, France.
J Nucl Cardiol. 2006 Mar-Apr;13(2):233-43. doi: 10.1007/BF02971248.
Electrocardiography-gated single photon emission computed tomography (SPECT) radionuclide angiography (RNA) provides accurate measurement of both left ventricular (LV) ejection fraction (EF) and end-diastolic and end-systolic volumes. In this study we studied the interstudy precision and reliability of SPECT RNA as compared with planar RNA for the measurement of global systolic LV function.
The population included 10 patients with chronic coronary artery disease having 2 sets of acquisitions, each consisting of planar and SPECT RNA. SPECT RNA was processed with SPECT-QBS and SPECT-35%. (For SPECT-35%, a manual segmentation method based on the 35% threshold of the maximum LV cavity activity is used to provide estimates of the number of voxels and the activity included in the LV cavity. The calculated LV number of voxels is then used to calculate LV volume measurement. The LV EF is calculated as the ratio of LV end-diastolic and end-systolic activity.) For LV EF, end-diastolic volume, and end-systolic volume, the interstudy precision, as reflected by the correlation coefficient, coefficient of variability, coefficient of repeatability, and within-subject coefficient of variation, and the interstudy reliability, as reflected by the intraclass correlation coefficient, were best with SPECT-35%, followed by planar RNA and then SPECT-QBS, respectively. The sample size needed to objectify a change in a parameter of LV function is lowest with SPECT-35%, followed by planar RNA and then SPECT-QBS, respectively.
The SPECT-35% processing method provides excellent interstudy precision and reliability for LV function measurement. In this aspect it seems to be better than planar RNA and SPECT-QBS. These results need to be confirmed in a larger patient population.
心电图门控单光子发射计算机断层扫描（SPECT）放射性核素血管造影（RNA）可准确测量左心室（LV）射血分数（EF）以及舒张末期和收缩末期容积。在本研究中，我们研究了与平面RNA相比，SPECT RNA在测量左心室整体收缩功能方面的研究间精密度和可靠性。
研究对象包括10例慢性冠状动脉疾病患者，他们进行了两组采集，每组包括平面和SPECT RNA。SPECT RNA采用SPECT-QBS和SPECT-35%进行处理。（对于SPECT-35%，基于左心室腔最大活性的35%阈值的手动分割方法用于提供左心室腔内体素数量和活性的估计值。然后使用计算出的左心室体素数量来计算左心室容积测量值。左心室EF通过左心室舒张末期和收缩末期活性的比值计算得出。）对于左心室EF、舒张末期容积和收缩末期容积，研究间精密度（由相关系数、变异系数、重复性系数和受试者内变异系数反映）和研究间可靠性（由组内相关系数反映）在SPECT-35%时最佳，其次分别是平面RNA和SPECT-QBS。客观化左心室功能参数变化所需的样本量在SPECT-35%时最低，其次分别是平面RNA和SPECT-QBS。
SPECT-35%处理方法在测量左心室功能方面提供了出色的研究间精密度和可靠性。在这方面，它似乎优于平面RNA和SPECT-QBS。这些结果需要在更大的患者群体中得到证实。
