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高速心肌灌注成像与传统双探测器安杰尔相机成像的初步临床比较。

High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging.

作者信息

Sharir Tali, Ben-Haim Simona, Merzon Konstantine, Prochorov Vitali, Dickman Dalia, Ben-Haim Shlomo, Berman Daniel S

机构信息

Procardia-Maccabi Healthcare Services, Tel-Aviv, Israel.

出版信息

JACC Cardiovasc Imaging. 2008 Mar;1(2):156-63. doi: 10.1016/j.jcmg.2007.12.004.

DOI:10.1016/j.jcmg.2007.12.004

PMID:19356422

Abstract

OBJECTIVES

The purpose of this study was to compare myocardial perfusion imaging (MPI) with high-speed single-photon emission computed tomography (SPECT) with conventional SPECT imaging for the evaluation of myocardial perfusion in patients with known or suspected coronary artery disease.

BACKGROUND

A novel technology has been developed for high-speed SPECT MPI by employing a bank of independently controlled detector columns with large-hole tungsten collimators and multiple cadmium zinc telluride crystal arrays.

METHODS

A total of 44 patients (39 men) underwent same-day Tc-99m sestamibi stress/rest MPI. High-speed SPECT images were performed within 30 min after conventional SPECT. Stress and rest acquisition times were 16 and 12 min for conventional imaging and 4 and 2 min for high-speed SPECT, respectively. Myocardial counts/min (cpm) were calculated for both conventional SPECT and high-speed SPECT. Images were visually analyzed, and the summed stress score (SSS) and summed rest score (SRS) were calculated. Image quality and diagnostic confidence were qualitatively assessed.

RESULTS

High-speed SPECT SSS and SRS correlated linearly with conventional SPECT respective scores (r = 0.93, p < 0.0001 for SSS, and r = 0.93, p < 0.0001 for SRS). Image quality was rated good and higher in 17 (94%) cases for high-speed SPECT and 16 (89%) cases for conventional SPECT. Of the 44 patients studied, 36 (81.8%) and 35 (79.5%) were diagnosed definitely normal or abnormal by conventional and high-speed SPECT, respectively (p = NS). Myocardial count rate was significantly higher in high-speed versus conventional SPECT (384 x 10(-3) +/- 134 x 10(-3) cpm/min vs. 47 x 10(-3) +/- 14 x 10(-3) cpm/min, respectively, p < 0.0001) for stress and (962 x 10(-3) +/- 426 x 10(-3) cpm/min vs. 136 x 10(-3) +/- 37 x 10(-3) cpm/min, respectively, p < 0.001) for rest.

CONCLUSIONS

High-speed SPECT provides fast MPI with high image quality and up to 8 times increased system sensitivity. The amount of perfusion abnormality visualized by high-speed SPECT is highly correlated to conventional SPECT, with an equivalent level of diagnostic confidence.

摘要

目的

本研究旨在比较高速单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）与传统SPECT成像在评估已知或疑似冠状动脉疾病患者心肌灌注方面的差异。

背景

通过采用一组带有大孔钨准直器的独立控制探测器列和多个碲化镉锌晶体阵列，已开发出一种用于高速SPECT MPI的新技术。

方法

共有44例患者（39例男性）同日接受了Tc-99m司他米比负荷/静息MPI检查。在传统SPECT检查后30分钟内进行高速SPECT图像采集。传统成像的负荷和静息采集时间分别为16分钟和12分钟，高速SPECT分别为4分钟和2分钟。计算传统SPECT和高速SPECT的心肌每分钟计数（cpm）。对图像进行视觉分析，并计算负荷总分（SSS）和静息总分（SRS）。对图像质量和诊断信心进行定性评估。

结果

高速SPECT的SSS和SRS与传统SPECT各自的分数呈线性相关（SSS的r = 0.93，p < 0.0001；SRS的r = 0.93，p < 0.0001）。高速SPECT有17例（94%）图像质量评级为良好及以上，传统SPECT有16例（89%）。在44例研究患者中，传统SPECT和高速SPECT分别明确诊断为正常或异常的有36例（81.8%）和35例（79.5%）（p =无显著性差异）。高速SPECT的心肌计数率在负荷时显著高于传统SPECT（分别为384×10⁻³±134×10⁻³ cpm/min对47×10⁻³±14×10⁻³ cpm/min，p < 0.0001），静息时为（962×10⁻³±426×10⁻³ cpm/min对136×10⁻³±37×10⁻³ cpm/min，p < 0.001）。