Wang Shan-Ying, Cheng Mei-Fang, Hwang Juey-Jen, Hung Chi-Sheng, Wu Yen-Wen
Department of Nuclear Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
Nucl Med Commun. 2011 Feb;32(2):113-20. doi: 10.1097/MNM.0b013e3283422838.
The left ventricular (LV) ejection fraction (EF) and end-diastolic and end-systolic volumes are strong predictors for prognosis of cardiac death. Quantitative-gated myocardial perfusion single-photon emission computed tomography (SPECT) is widely used to measure LV functional parameters. However, systematic differences may exist between referred populations. We sought to derive sex-specific normal values for LV functional parameters obtained using two quantitative methods.
Among 1044 consecutive patients who underwent dipyridamole stress myocardial perfusion-gated 201Tl SPECT in 2008, a total of 140 (56 men) with normal perfusion imaging were selected. None had cardiac diseases or experienced cardiac events during 1-year follow-up. LV EF and end-diastolic and end-systolic volumes were calculated by quantitative-gated SPECT (QGS) and four-dimensional-myocardial single photon emission computed tomography (4D-MSPECT), respectively.
There was excellent intrareader and interreader reproducibility for both QGS and 4D-MSPECT algorithms. The differences in LV volumes and EF between the software packages were small. High prevalence of small heart was noted in the study population, especially in women (>60%). Volumetric measures were significantly greater (P<0.001) in men than in women, even after adjustment for body surface area. Women had a higher LV EF than men when using QGS methods, but not when using the 4D-MSPECT method. Compared with 4D-MSPECT, sex remained significantly associated with EF determined by QGS methods, independent of age and body weight.
LV functional parameters determined by means of gated 201Tl SPECT need to be corrected for sex and algorithms. Separate reference values of LV EF and volumes need to be applied in both women and men depending on the software package used.
左心室（LV）射血分数（EF）以及舒张末期和收缩末期容积是心脏性死亡预后的有力预测指标。定量门控心肌灌注单光子发射计算机断层扫描（SPECT）被广泛用于测量左心室功能参数。然而，不同转诊人群之间可能存在系统差异。我们试图得出使用两种定量方法获得的左心室功能参数的性别特异性正常值。
在2008年连续接受双嘧达莫负荷心肌灌注门控201Tl SPECT检查的1044例患者中，共选取了140例（56例男性）灌注成像正常的患者。在1年随访期间，无一例患有心脏病或经历心脏事件。左心室EF以及舒张末期和收缩末期容积分别通过定量门控SPECT（QGS）和四维心肌单光子发射计算机断层扫描（4D-MSPECT）计算得出。
QGS和4D-MSPECT算法在阅片者内和阅片者间均具有出色的可重复性。两个软件包之间左心室容积和EF的差异很小。研究人群中发现小心脏的患病率很高，尤其是在女性中（>60%）。即使在调整体表面积后，男性的容积测量值仍显著高于女性（P<0.001）。使用QGS方法时，女性的左心室EF高于男性，但使用4D-MSPECT方法时并非如此。与4D-MSPECT相比，性别仍然与QGS方法测定的EF显著相关，独立于年龄和体重。
通过门控201Tl SPECT测定的左心室功能参数需要根据性别和算法进行校正。根据所使用的软件包，男女均需要应用单独的左心室EF和容积参考值。
