Knaapen Paul, Lubberink Mark, Rijzewijk Luuk J, van der Meer Rutger W, Unger Michiel, Germans Tjeerd, Bax Jeroen J, Smit Jan W A, Lamb Hildo J, van Rossum Albert C, Diamant Michaela, Visser Frans C, Lammertsma Adriaan A
Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
J Nucl Cardiol. 2008 Mar-Apr;15(2):218-24. doi: 10.1016/j.nuclcard.2007.11.016.
The assessment of forward stroke volume (SV) using dynamic, first-pass cardiac positron emission tomography (PET) was shown to be feasible in a limited number of studies with small numbers of subjects. The aim of this study was to compare first-pass derived SV with cardiovascular magnetic resonance imaging (CMR)-obtained values in a larger population of subjects.
Fifty-nine subjects with varying degrees of cardiac function were studied. Stroke volume was assessed using oxygen-15-labeled water (H(2)(15)O) dynamic first-pass PET for both the right ventricle (RV) and left ventricle (LV), and compared with the findings of aorta velocity-encoded phase-contrast CMR. The PET-estimated SV was higher for the RV than for the LV (133 +/- 34 vs 116 +/- 31 mL, P < .01, +/- SD), and both were higher compared with values obtained by CMR (81 +/- 20 mL, both P < .01, +/- SD). Although significant, the correlations between PET and CMR were moderate for both the RV (r = 0.37, P < .01) and the LV (r = 0.40, P < .01, +/- SD). Bland-Altman analysis revealed a progressive overestimation with increasing SV measured in either ventricle.
First-pass dynamic H(2)(15)O PET for the assessment of forward SV is feasible, although values are progressively overestimated with increasing SV, particularly when the RV is used, and correlations with aorta velocity-encoded phase-contrast CMR are moderate. These findings are probably protocol-dependent and warrant further study before the use of first-pass dynamic H(2)(15)O PET in clinical or research settings can be advocated.
在少数小规模研究中,已证明使用动态首次通过心脏正电子发射断层扫描(PET)评估前向每搏输出量(SV)是可行的。本研究的目的是在更大规模的受试者群体中,比较首次通过PET得出的SV与心血管磁共振成像(CMR)获得的值。
对59名心功能不同程度的受试者进行了研究。使用氧-15标记水(H₂¹⁵O)动态首次通过PET评估右心室(RV)和左心室(LV)的每搏输出量,并与主动脉速度编码相位对比CMR的结果进行比较。PET估计的RV每搏输出量高于LV(133±34 vs 116±31 mL,P<.01,±标准差),且两者均高于CMR获得的值(81±20 mL,P均<.01,±标准差)。尽管具有显著性,但PET与CMR之间的相关性对于RV(r = 0.37,P<.01)和LV(r = 0.40,P<.01,±标准差)均为中等。Bland-Altman分析显示,随着任一心室测量的SV增加,存在逐渐高估的情况。
首次通过动态H₂¹⁵O PET评估前向SV是可行的,尽管随着SV增加,值会逐渐被高估(尤其是使用RV时),且与主动脉速度编码相位对比CMR的相关性为中等。这些发现可能取决于方案,在提倡将首次通过动态H₂¹⁵O PET用于临床或研究之前,有必要进行进一步研究。