Jensen Maria Maj, Schmidt Ulla, Huang Chenxi, Zerahn Bo
Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Herstedvesterstræde 54, 2620, Albertslund, Denmark,
J Nucl Cardiol. 2014 Apr;21(2):384-96. doi: 10.1007/s12350-013-9844-6. Epub 2013 Dec 24.
Estimation of left ventricular ejection fraction (LVEF) with equilibrium 99MTc-HSA equilibrium radionuclide angiography (MUGA) is frequently used for assessing cardiac function. The purpose of this study was to compare intra- and interobserver variation between three different gamma cameras.
Eighty-two patients, scanned in the same sequential order on the three cameras. Each acquisition was analyzed twice by two technologists. Inter- and intraobserver variations were calculated as the coefficient of variation and the 95% confidence interval for limits of agreement between each sequence of analyses for each of the three cameras.
The lowest intraobserver variations in LVEF for the two NaI-detector cameras were 3.1% (-4.0% to 3.5%) for the planar and 3.4% (-4.2% to 4.5%) for SPECT (P ≤ 0.001-0.019), the highest result for the CZT SPECT camera was 2.6% (-2.9% to 3.1%). Similarly, interobserver variation was 4.8% (-4.8% to 6.4%) and 4.9% (-5.4% to 7.5%), respectively, for each of the NaI-detector cameras and 3.3% (-3.4% to 4.3%) for the CZT SPECT camera (P ≤ 0.001-0.008).
The CZT detector camera was superior to both NaI detector cameras regarding intra- and interobserver variation. The CZT SPECT camera may identify changes in LVEF with greater certainty than its NaI detector-equipped counterparts.
采用平衡法99锝-人血清白蛋白平衡放射性核素血管造影(MUGA)估算左心室射血分数(LVEF)常用于评估心脏功能。本研究的目的是比较三种不同γ相机之间的观察者内和观察者间差异。
82例患者在三台相机上按相同顺序进行扫描。每次采集由两名技术人员分析两次。观察者间和观察者内差异计算为变异系数以及三台相机中每台相机每次分析序列之间一致性界限的95%置信区间。
两台碘化钠探测器相机LVEF的最低观察者内差异,平面显像为3.1%(-4.0%至3.5%),单光子发射计算机断层显像(SPECT)为3.4%(-4.2%至4.5%)(P≤0.001 - 0.019),碲锌镉(CZT)SPECT相机的最高结果为2.6%(-2.9%至3.1%)。同样,碘化钠探测器相机的观察者间差异分别为4.8%(-4.8%至6.4%)和4.9%(-5.4%至7.5%),CZT SPECT相机为3.3%(-3.4%至4.3%)(P≤0.001 - 0.008)。
在观察者内和观察者间差异方面,CZT探测器相机优于两台碘化钠探测器相机。与配备碘化钠探测器的相机相比,CZT SPECT相机可能更能确定地识别LVEF的变化。