Canbaz Fevziye, Basoglu Tarik, Durna Kenan, Semirgin Sibel Ucak, Canbaz Sevgi
Department of Nuclear Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Int J Cardiovasc Imaging. 2008 Aug;24(6):585-96. doi: 10.1007/s10554-008-9298-0. Epub 2008 Feb 16.
The objective of this trial was to investigate the capacity of gated perfusion SPECT (GPS) to detect left ventricular aneurysm (ANV) by comparing QGS and 4D-MSPECT (4DM) algorithms with radionuclide ventriculography (RVG). Secondarily, the comparison of GPS ejection fraction (EF) measurements with those of contrast left ventriculography (LVG) and RVG was aimed.
Twenty-five patients with ANV confirmed by LVG were studied. The patients underwent RVG and rest Tc-99m-tetrofosmin GPS 1 week after LVG. A 9-segment model was used both in RVG and GPS evaluation. Aneurysm was defined by scoring the wall motion (WM) and phase analysis in RVG; perfusion, wall thickening and WM in GPS.
The detection rate of ANV was 96%, 84% and 52% for RVG, QGS and 4DM, respectively. The LVG mean EF (43.52% +/- 16.93%) was significantly higher (P < 0.01) than those of RVG (29.40% +/- 10.90), QGS (30.04% +/- 13.25%) and 4DM (34.92% +/- 13.01%). Moderate to high EF correlation values were obtained between LVG and GPS (r = 0.71-0.79) and GPS-RVG (r = 0.69). There was no significant EF difference between the radionuclide methods except between 4DM-EF and RVG-EF (5.52%, P < 0.05). Wide Bland-Altman limits were observed between the radionuclide methods in EF comparisons (range: 30.5-38.5%).
GPS seems to have a role in the non-invasive investigation of ANV. QGS-GPS proved to be more reliable (84%) than 4DM-GPS (52%) in the ANV detection. The localization and the extent of the aneurysm itself as well as perfusion and function of adjacent segments may affect aneurysm diagnosis by means of GPS. RVG, QGS-GPS and 4DM-GPS seem not to be interchangeable for routine EF calculation in ANV patients.
本试验的目的是通过将定量门控单光子发射计算机断层扫描（QGS）和四维心肌灌注单光子发射计算机断层扫描（4D-MSPECT，4DM）算法与放射性核素心室造影（RVG）相比较，研究门控灌注单光子发射计算机断层扫描（GPS）检测左心室室壁瘤（ANV）的能力。其次，旨在比较GPS射血分数（EF）测量值与对比剂左心室造影（LVG）和RVG的测量值。
研究25例经LVG确诊为ANV的患者。患者在LVG后1周接受RVG和静息状态下的锝-99m-替曲膦GPS检查。RVG和GPS评估均采用9节段模型。通过对RVG中的室壁运动（WM）和相位分析进行评分来定义室壁瘤；通过对GPS中的灌注、室壁增厚和WM进行评分来定义室壁瘤。
RVG、QGS和4DM对ANV的检出率分别为96%、84%和52%。LVG的平均EF（43.52%±16.93%）显著高于RVG（29.40%±10.90）、QGS（30.04%±13.25%）和4DM（34.92%±13.01%）（P<0.01）。LVG与GPS（r=0.71-0.79）以及GPS-RVG（r=0.69）之间获得了中度至高的EF相关值。除4DM-EF与RVG-EF之间（5.52%，P<0.05）外，放射性核素方法之间的EF差异无统计学意义。在EF比较中，放射性核素方法之间观察到较宽的布兰德-奥特曼界限（范围：30.5-38.5%）。
GPS似乎在ANV的无创检查中发挥作用。在ANV检测中，QGS-GPS（84%）被证明比4DM-GPS（52%）更可靠。室壁瘤本身的定位和范围以及相邻节段的灌注和功能可能会影响通过GPS进行的室壁瘤诊断。在ANV患者的常规EF计算中，RVG、QGS-GPS和4DM-GPS似乎不可互换使用。
