心脏 SPECT 衰减校正 CT 扫描的主肺动脉直径准确预测肺动脉高压。
Main pulmonary artery diameter from attenuation correction CT scans in cardiac SPECT accurately predicts pulmonary hypertension.
机构信息
Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
出版信息
J Nucl Cardiol. 2011 Aug;18(4):634-41. doi: 10.1007/s12350-011-9413-9. Epub 2011 Jun 18.
OBJECTIVES
To establish the value of the main pulmonary artery (MPA) diameter assessed from unenhanced computer tomography (CT) scans used for attenuation correction (AC) of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to predict pulmonary hypertension (PHT).
BACKGROUND
In contrast-enhanced chest CT scans an MPA diameter of 29 mm or greater is an established predictor of PHT. However, it is unknown, whether measurements from an unenhanced CT scan for AC may be used as predictor of PHT.
METHODS
100 patients underwent SPECT MPI for assessment of coronary artery disease. PHT was defined as a right ventriculo-atrial gradient of 30 mm Hg or greater by Doppler echocardiography. We compared MPA diameter from CT to SPECT findings (right ventricular hypertrophy/enlargement, septal wall motion abnormality/perfusion defect, and D-shape) to determine the best predictor of PHT.
RESULTS
PHT was found in 37 patients. An MPA diameter of 30 mm or greater yielded a sensitivity, specificity, accuracy, positive, and negative predictive value of 78%, 91%, 86%, 83%, and 88%, respectively. This yielded an area under the ROC curve of 0.85.
CONCLUSIONS
MPA diameter from low-dose unenhanced multi-slice CT reliably predicts PHT, providing an important added clinical value from AC for SPECT MPI.
目的
利用单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）衰减校正（AC）中所使用的未增强计算机断层扫描（CT）评估的主肺动脉（MPA）直径，确定其预测肺动脉高压（PHT）的价值。
背景
在增强胸部 CT 扫描中，MPA 直径≥29mm 是 PHT 的既定预测指标。然而，目前尚不清楚用于 AC 的未增强 CT 扫描测量值是否可作为 PHT 的预测指标。
方法
100 例患者行 SPECT MPI 检查以评估冠状动脉疾病。右心室-心房梯度≥30mmHg 时经多普勒超声心动图诊断为 PHT。我们比较了 CT 与 SPECT 检查结果（右心室肥厚/扩大、室间隔壁运动异常/灌注缺损和 D 形）中的 MPA 直径，以确定 PHT 的最佳预测指标。
结果
37 例患者存在 PHT。MPA 直径≥30mm 的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 78%、91%、86%、83%和 88%。ROC 曲线下面积为 0.85。
结论
低剂量多层 CT 中的 MPA 直径可可靠地预测 PHT，为 SPECT MPI 的 AC 提供了重要的附加临床价值。
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