Khorsand Aliasghar, Gyöngyösi Mariann, Graf Senta, Zamini Sholeh, Schuster Ernst, Sochor Heinz, Porenta Gerold
Department of Cardiology, Medical University of Vienna, Rudolfinerhaus, Vienna, Austria.
Nucl Med Commun. 2009 Apr;30(4):300-7. doi: 10.1097/MNM.0b013e3283294d19.
The purpose of this study was to compare quantitative ECG-gated single-photon emission computed tomography (SPECT) (QGS) and model-based ECG-gated single-photon emission computed tomography (MBGS) for determination of end-diastolic cardiac volume (EDV), end-systolic cardiac volume (ESV), and left ventricular ejection fraction (LVEF). The accuracy of both methods was evaluated by measurements obtained from contrast left ventriculography (LVG).
Forty-five patients (40 male, age: 55+/-11 years) with coronary artery disease were studied by angiography and ECG-gated SPECT using technetium-99m-sestamibi for the evaluation of myocardial perfusion and LVEF. Short axis SPECT images were analyzed by QGS and MBGS to estimate endocardial and epicardial surfaces and to derive EDV, ESV, and LVEF.
EDV by gated SPECT (QGS: 187+/-71 ml; MBGS: 191+/-76 ml) were lower than corresponding values by LVG (203+/-59 ml), whereas ESV by gated SPECT (QGS: 121+/-62 ml; MBGS: 108+/-54 ml) were higher than by LVG (105+/-49 ml). Thus, LVEFs by gated SPECT (QGS: 39+/-12%; MBGS: 45+/-9%) were significantly lower than by LVG (50+/-15%). LVEF by MBGS was significantly higher than by QGS (P<0.05). A significant correlation was observed among QGS, MBGS, and LVG for the calculation of EDV, ESV, and LVEF.
Measurements of LV volumes and LVEF by QGS and MBGS showed close agreement with each other and with results from LVG. However, both methods measure lower values for EDV and higher values for ESV and thus underestimate LVEF compared with LVG.
本研究旨在比较定量心电图门控单光子发射计算机断层扫描（SPECT）（QGS）和基于模型的心电图门控单光子发射计算机断层扫描（MBGS）在测定舒张末期心脏容积（EDV）、收缩末期心脏容积（ESV）和左心室射血分数（LVEF）方面的差异。通过对比左心室造影（LVG）获得的测量值来评估这两种方法的准确性。
对45例（40例男性，年龄：55±11岁）冠心病患者进行血管造影和使用锝-99m-甲氧基异丁基异腈的心电图门控SPECT检查，以评估心肌灌注和LVEF。通过QGS和MBGS分析短轴SPECT图像，以估计心内膜和心外膜表面，并得出EDV、ESV和LVEF。
门控SPECT测定的EDV（QGS：187±71 ml；MBGS：191±76 ml）低于LVG测定的相应值（203±59 ml），而门控SPECT测定的ESV（QGS：121±62 ml；MBGS：108±54 ml）高于LVG测定的ESV（105±49 ml）。因此，门控SPECT测定的LVEF（QGS：39±12%；MBGS：45±9%）显著低于LVG测定的LVEF（50±15%）。MBGS测定的LVEF显著高于QGS（P<0.05）。在计算EDV、ESV和LVEF时，QGS、MBGS和LVG之间存在显著相关性。
QGS和MBGS测定的左心室容积和LVEF相互之间以及与LVG的结果显示出密切的一致性。然而，与LVG相比，这两种方法测定的EDV值较低，ESV值较高，因此低估了LVEF。
