Akhter Nasima, Nakajima Kenichi, Okuda Koichi, Matsuo Shinro, Yoneyama Tatsuya, Taki Junichi, Kinuya Seigo
Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, Japan.
Eur J Nucl Med Mol Imaging. 2008 Sep;35(9):1608-15. doi: 10.1007/s00259-008-0804-3. Epub 2008 Apr 29.
Gated single-photon emission computed tomography (SPECT) imaging of myocardium by (99m)Tc and (201)Tl is used extensively to measure quantitative cardiac functional parameters. However, factors affecting normal values for myocardial functional parameters and population-specific standards have not yet been established. The aim of the study was to determine the effect of sex, radiotracer, rotation angles and frame rates on resting myocardial wall thickening (WT) and to develop a Japanese standard of normal values for WT.
Data from a total of 202 patients with low possibility of having cardiac problems were collected from nine hospitals throughout Japan. Patients were divided into five groups according to study protocol, and WT was evaluated according to the 17-segment and four-region (basal, mid and apical regions and the apex) polar map distribution.
WT was generally higher in women than in men irrespective of the use of radiotracers, rotation angles or frame rates, and the difference was highly significant in the mid and apical regions. In any protocol used, resting myocardial thickening in the apex was higher than in the mid and apical regions, and thickening was lowest in the basal region, suggesting heterogeneous regional myocardial thickening (%) in normal subjects. Different rotation angles showed no significant change on WT, but different frame rates and tracers showed significant WT change in both sexes. Percent thickening of the myocardium was significantly higher in imaging by (99m)Tc-labelled tracers than in (201)Tl.
Sex, radiotracers and frame rates had a significant effect on myocardial thickening, and the importance of population-specific standards should be emphasized. A normal database can serve as a standard for gated SPECT evaluation of myocardial thickening in a Japanese population and might be applicable to Asian populations having a similar physique.
利用（99m）锝和（201）铊进行心肌门控单光子发射计算机断层扫描（SPECT）成像被广泛用于测量定量心脏功能参数。然而，影响心肌功能参数正常值的因素以及特定人群标准尚未确立。本研究的目的是确定性别、放射性示踪剂、旋转角度和帧率对静息心肌壁增厚（WT）的影响，并制定日本WT正常值标准。
从日本全国九家医院收集了总共202例心脏问题可能性较低的患者的数据。根据研究方案将患者分为五组，并根据17节段和四区（基底、中间和心尖区域以及心尖）极坐标图分布评估WT。
无论使用何种放射性示踪剂、旋转角度或帧率，女性的WT普遍高于男性，且在中间和心尖区域差异非常显著。在任何使用的方案中，心尖处的静息心肌增厚高于中间和心尖区域，且基底区域增厚最低，提示正常受试者区域心肌增厚（%）存在异质性。不同的旋转角度对WT无显著影响，但不同的帧率和示踪剂在两性中均显示出WT的显著变化。（99m）锝标记示踪剂成像时心肌增厚百分比显著高于（201）铊。
性别､放射性示踪剂和帧率对心肌增厚有显著影响，应强调特定人群标准的重要性。一个正常数据库可作为日本人群心肌增厚门控SPECT评估的标准，可能适用于具有相似体格的亚洲人群。
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