Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital of Ruhr University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany.
Eur J Nucl Med Mol Imaging. 2011 Aug;38(8):1485-92. doi: 10.1007/s00259-011-1777-1. Epub 2011 Apr 19.
Since 2006, the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine, in cooperation with the working group Nuclear Cardiology of the German Cardiac Society, has been surveying the utilization and technical realization of myocardial perfusion scintigraphy (MPS) in Germany. This paper presents the results of the reporting year 2009.
A total of 291 centres participated in the inquiry, including 179 private practices (PP), 86 hospitals (HO) and 26 university hospitals (UH).
MPS of 98,103 patients were reported. The MPS numbers per million population (pmp) were estimated at 2,360; 76% of the MPS were performed in PP, 17% in HO and 7% in UH. The ratio of MPS to coronary angiography to revascularization was 0.5 to 2.3 to 1. Data from 134 centres which participated in the surveys from 2005 to 2009 showed a decrease in MPS utilization of 2.2%. Nearly half of the MPS were requested by ambulatory care cardiologists. Of all MPS studies, 89% were conducted with (99m)Tc perfusion tracers. Ergometry was the preferred stress test (69%). Adenosine was used in 16%, adenosine + exercise in 7%, dipyridamole in 3%, dipyridamole + exercise in 5% and dobutamine in <1%. Gated single proton emission computed tomography (SPECT) acquisition was performed in 56% of all rest MPS and in 56% of all stress MPS. Both rest and stress MPS were ECG gated in 41%. Only 33% of the centres always performed a quantification of the perfusion studies, whereas 51% did not apply any quantification; 4% of the MPS studies were corrected for attenuation, and 17 centres used transmission sources of 12 CT-based systems.
A scan activity of 2,380 MPS pmp is in the upper third of the European range. The ratios to coronary angiography and to revascularization suggest that angiography dominates diagnosis and management of coronary artery disease (CAD). The clinical and technical realizations reveal that the predominant goals of further trainings to optimize MPS are in the field of gated SPECT and quantitative perfusion SPECT.
自 2006 年以来，德国核医学会心血管核医学工作组与德国心脏病学会核心脏学工作组合作，一直在调查德国心肌灌注闪烁显像（MPS）的应用和技术实现情况。本文介绍了 2009 年报告年度的结果。
共有 291 个中心参与了调查，包括 179 个私人诊所（PP）、86 个医院（HO）和 26 个大学医院（UH）。
报告了 98103 例患者的 MPS。每百万人口的 MPS 数（pmp）估计为 2360；76%的 MPS 在 PP 中进行，17%在 HO 中进行，7%在 UH 中进行。MPS 与冠状动脉造影和血运重建的比例为 0.5 比 2.3 比 1。参加 2005 年至 2009 年调查的 134 个中心的数据显示，MPS 的利用率下降了 2.2%。近一半的 MPS 是由门诊心脏病专家要求的。所有 MPS 研究中，89%使用（99m）Tc 灌注示踪剂进行。负荷试验（69%）是首选的应激试验。腺苷的使用率为 16%，腺苷+运动的使用率为 7%，双嘧达莫的使用率为 3%，双嘧达莫+运动的使用率为 5%，多巴酚丁胺的使用率小于 1%。静息 MPS 的 56%和应激 MPS 的 56%均采用门控单光子发射计算机断层扫描（SPECT）采集。41%的 MPS 同时进行静息和应激心电图门控。只有 33%的中心始终对灌注研究进行定量，而 51%的中心不进行任何定量；4%的 MPS 研究进行了衰减校正，17 个中心使用了 12 个 CT 系统的传输源。
MPS 的扫描活动处于欧洲范围的较高水平，MPS 与冠状动脉造影和血运重建的比值表明，血管造影在诊断和治疗冠状动脉疾病（CAD）方面占主导地位。临床和技术实现表明，进一步培训的主要目标是优化门控 SPECT 和定量灌注 SPECT。
