Katohno E, Ono K, Owada K, Fujino A, Watanabe N, Sato M, Konno I, Yaoita H, Tsuda F, Kariyone S
First Department of Internal Medicine, Fukushima Medical College.
J Cardiol. 1987 Jun;17(2):329-39.
To determine right (RV) and left ventricular (LV) volumes, a new technique was developed using ECG-gated single-photon emission computed tomography (SPECT). RV volumes of nine patients and LV volumes of 22 patients measured by SPECT and biplane contrast cineangiography were compared. In addition, volume and ejection fraction (EF) of the RV and LV were obtained by SPECT for 10 normal controls, 21 patients with old myocardial infarction (OMI), eight patients with hypertrophic cardiomyopathy (HCM) and 12 patients with dilated cardiomyopathy (DCM), and these results were compared. The intracardiac blood pool was labeled with Tc-99m sodium pertechnetate and 32 images were recorded through 180 degrees by a rotating gamma-camera. End-diastolic and end-systolic counts during 50 msec were recorded during 50 or 60 cardiac cycles. These counting data were reconstructed as tomographic images of vertical long-axial slices with thickness of a pixel without any attenuation correction. The numbers of voxels within the % cut-off level were summed, and the sum was multiplied by the one voxel volume. The cut-off level for ventricular delineation was determined as 45% by phantom studies. 1. The values obtained from SPECT and contrast angiography correlated well. 2. In normal controls, LV end-diastolic and end-systolic volumes were significantly less than those of the RV (p less than 0.05, p less than 0.001) and LVEF was significantly greater than the RVEF (p less than 0.001). 3. In OMI (single vessel disease), both end-diastolic and end-systolic volumes of the LV were significantly greater than those of normals (p less than 0.01, p less than 0.001) and LVEF was significantly less. In HCM end-systolic volumes of the RV were significantly less (p less than 0.05) than those of the normals. 4. LV volume was greater and LVEF was extremely low both in DCM and in OMI (multivessel disease) compared to that of the normals. In DCM, RV end-systolic volumes was greater and RVEF was lower than that of OMI (multi-vessel disease), indicating the deterioration of RV contractility , primarily in DCM. From these findings, it was concluded that this noninvasive technique may be useful for estimating left and right ventricular volumes.
为了测定右心室（RV）和左心室（LV）容积，开发了一种使用心电图门控单光子发射计算机断层扫描（SPECT）的新技术。比较了通过SPECT和双平面造影电影血管造影术测量的9例患者的右心室容积和22例患者的左心室容积。此外，通过SPECT获得了10名正常对照者、21例陈旧性心肌梗死（OMI）患者、8例肥厚型心肌病（HCM）患者和12例扩张型心肌病（DCM）患者的右心室和左心室容积及射血分数（EF），并对这些结果进行了比较。用锝-99m高锝酸钠标记心腔内血池，通过旋转γ相机在180度范围内记录32幅图像。在50或60个心动周期中记录50毫秒内的舒张末期和收缩末期计数。这些计数数据被重建为垂直长轴切片的断层图像，像素厚度，未进行任何衰减校正。对%截止水平内的体素数量求和，并将总和乘以一个体素体积。通过模型研究确定心室轮廓的截止水平为45%。1.从SPECT和造影血管造影获得的值相关性良好。2.在正常对照者中，左心室舒张末期和收缩末期容积显著小于右心室（p<0.05，p<0.001），左心室射血分数显著大于右心室射血分数（p<0.001）。3.在OMI（单支血管病变）中，左心室舒张末期和收缩末期容积均显著大于正常对照者（p<0.01，p<0.001），左心室射血分数显著降低。在HCM中，右心室收缩末期容积显著小于正常对照者（p<0.05）。4.与正常对照者相比，DCM和OMI（多支血管病变）患者的左心室容积更大，左心室射血分数极低。在DCM中，右心室收缩末期容积大于OMI（多支血管病变）患者，右心室射血分数低于OMI患者，表明右心室收缩性恶化，主要发生在DCM中。从这些发现得出结论，这种非侵入性技术可能有助于估计左、右心室容积。
