利用慢性肾病患者的动态单光子发射计算机断层扫描图像对心肌灌注储备进行定量分析。
Quantification of myocardial perfusion reserve using dynamic SPECT images of patients with chronic kidney disease.
作者信息
Tsuda Noriko, Shiraishi Shinya, Sakamoto Fumi, Yuki Hideaki, Ogasawara Koji, Yoshida Morikatsu, Tomiguchi Seiji, Tsujita Kenichi, Yamashita Yasuyuki
机构信息
Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
出版信息
J Cardiol. 2018 Feb;71(2):174-180. doi: 10.1016/j.jjcc.2017.07.009. Epub 2017 Aug 31.
BACKGROUND
Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disorders. The aim of this study was to examine whether the quantitatively measured myocardial blood flow (MBF) or myocardial perfusion reserve (MPR), calculated by dynamic single photon emission computed tomography (SPECT) analysis using a cardiac cadmium zinc telluride (CZT) gamma camera, was related to renal dysfunction in patients with normal myocardial perfusion imaging (MPI) findings.
METHODS
The study population consisted of 46 patients with CKD and 46 individuals without CKD (controls). Their MPR index was quantitatively measured using adenosine MPI with a cardiac CZT gamma camera. All assessments were with a single tissue compartment kinetic model. The K1 value was calculated on stress and at-rest images. To obtain the MPR index we divided K1 stress-by K1 at-rest values.
RESULTS
The at-rest K1 value was significantly higher and the MPR index was significantly lower in patients with CKD than those without CKD [CKD vs.
CONTROLS
at-rest K1 value, 0.21 (0.17-0.25) vs. 0.19 (0.16-0.22), p=0.040; MPR index, 1.86 (1.69-2.22) vs. 2.19 (1.93-2.41), p<0.001]. The stress K1 values were not significantly different.
CONCLUSION
The MPR index is significantly lower in CKD patients; this is considered as being mainly due to an increase in the at-rest K1 value.
背景
慢性肾脏病（CKD）是心血管疾病的独立危险因素。本研究旨在探讨使用心脏碲化镉锌（CZT）γ相机通过动态单光子发射计算机断层扫描（SPECT）分析定量测量的心肌血流量（MBF）或心肌灌注储备（MPR）是否与心肌灌注成像（MPI）结果正常的患者的肾功能不全相关。
方法
研究人群包括46例CKD患者和46例无CKD的个体（对照组）。使用心脏CZTγ相机通过腺苷MPI定量测量他们的MPR指数。所有评估均采用单组织隔室动力学模型。在负荷和静息图像上计算K1值。为了获得MPR指数，我们将负荷时的K1值除以静息时的K1值。
结果
CKD患者的静息K1值显著更高，MPR指数显著更低[CKD与对照组：静息K1值，0.21（0.17 - 0.25）对0.19（0.16 - 0.22），p = 0.040；MPR指数，1.86（1.69 - 2.22）对2.19（1.93 - 2.41），p < 0.001]。负荷时的K1值无显著差异。
结论
CKD患者的MPR指数显著更低；这被认为主要是由于静息K1值增加所致。
Zotero 插件