Christian P E, Nortmann C A, Taylor A
J Nucl Med. 1985 Jul;26(7):775-82.
Resting multigated blood-pool studies were performed on 61 patients without arrhythmias and data were simultaneously acquired to two computer systems. Using one computer, manual ejection fraction (EF) was calculated by two trained observers. EF was also calculated from the other computer using a commercially available fully automated program; quality control (QC) images were routinely obtained to evaluate correct left-ventricular center location, background region assignment, or gross edge mispositioning. When errors were noted, the automated analysis was reprocessed with operator intervention. Forty-eight of the 61 studies (78%) produced adequate QC images. Operator redefinition of the left ventricular center and background of the 13 QC failures raised the automated success level to 92%. Correlation of the manual EF by two observers was excellent (r = 0.969). The automated EF measurements correlated well with the average observer's (r = 0.898). An improved version of software reduced the QC failures from 13 to 10. Operator assisted automated processing gave the success rate of 94%. The remaining 6% of patients required manual processing to obtain a correct ejection fraction. Our normal range for manual EF is greater than or equal to 0.50 and our corresponding normal range for this group of patients using the automated program was greater than or equal to 0.44. Based on greater than or equal to 0.44, four patients with a low manual EF had a normal automated EF. All four patients had cardiac disease but there was no evidence of abnormal cardiac function. The fully automated program provided good correlation with manual EF and can remove some of the subjectivity in manual edge determination. However, QC images must be carefully examined and the normal EF range for the automated program must be determined.
对61例无心律失常的患者进行了静息多门控心血池显像研究，并同时将数据采集到两个计算机系统。使用一台计算机，由两名经过培训的观察者计算手动射血分数（EF）。还使用市售的全自动程序从另一台计算机计算EF；常规获取质量控制（QC）图像以评估左心室中心位置是否正确、背景区域分配是否正确或边缘是否存在明显错位。当发现错误时，在操作员干预下对自动分析进行重新处理。61项研究中有48项（78%）生成了足够的QC图像。操作员对13例QC失败病例的左心室中心和背景进行重新定义后，自动分析的成功率提高到了92%。两名观察者的手动EF相关性极佳（r = 0.969）。自动EF测量值与平均观察者的测量值相关性良好（r = 0.898）。软件的改进版本将QC失败病例从13例减少到了10例。操作员辅助的自动处理成功率为94%。其余6%的患者需要手动处理才能获得正确的射血分数。我们手动EF的正常范围大于或等于0.50，使用自动程序时该组患者相应的正常范围大于或等于0.44。基于大于或等于0.44的标准，4例手动EF较低的患者自动EF正常。所有4例患者均患有心脏病，但无心脏功能异常的证据。全自动程序与手动EF具有良好的相关性，并且可以消除手动边缘确定中的一些主观性。然而，必须仔细检查QC图像，并且必须确定自动程序的正常EF范围。
