瑞加德松诱导的心肌蠕变对动态铷-82 PET 心肌血流定量的影响。
Impact of regadenoson-induced myocardial creep on dynamic Rubidium-82 PET myocardial blood flow quantification.
机构信息
Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
出版信息
J Nucl Cardiol. 2019 Jun;26(3):719-728. doi: 10.1007/s12350-019-01649-4. Epub 2019 Feb 20.
BACKGROUND
Repositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification.
METHODS
We retrospectively included 119 consecutive patients who underwent dynamic rest- and regadenoson-induced stress MPI using Rb-82 PET. The presence of myocardial creep was visually assessed in the dynamic stress PET series by identifying differences between the automatically drawn myocardium contour and the activity. Uncorrected and corrected stress MBFs were compared for the three vascular territories (LAD, LCX, and RCA) and for the whole myocardium.
RESULTS
Myocardial creep was observed in 52% of the patients during stress. Mean MBF values decreased after correction in the RCA from 4.0 to 2.7 mL/min/g (P < 0.001), in the whole myocardium from 2.7 to 2.6 mL/min/g (P = 0.01), and increased in the LAD from 2.5 to 2.6 mL/min/g (P = 0.03) and remained comparable in the LCX (P = 0.3).
CONCLUSIONS
Myocardial creep is a frequent phenomenon when performing regadenoson-induced stress Rb-82 PET and has a significant impact on MBF values, especially in the RCA territory. As this may hamper diagnostic accuracy, myocardial creep correction seems necessary for reliable quantification.
背景
使用雷氯必利（regadenoson）进行铷-82（Rb-82）正电子发射断层扫描（PET）心肌灌注成像（MPI）时，心脏可能会重新定位。我们的目的是确定使用这种心肌蠕动校正方法对心肌血流（MBF）定量的影响。
方法
我们回顾性纳入了 119 例连续接受 Rb-82 PET 动态静息和雷氯必利诱导应激 MPI 的患者。通过识别自动绘制的心肌轮廓和活性之间的差异，在动态应激 PET 系列中对心肌蠕动进行视觉评估。比较了三个血管区域（LAD、LCX 和 RCA）和整个心肌的未校正和校正后的应激 MBF。
结果
52%的患者在应激期间观察到心肌蠕动。校正后 RCA 的 MBF 值从 4.0 降至 2.7 mL/min/g（P<0.001），整个心肌的 MBF 值从 2.7 降至 2.6 mL/min/g（P=0.01），LAD 的 MBF 值从 2.5 增至 2.6 mL/min/g（P=0.03），而 LCX 的 MBF 值无明显变化（P=0.3）。
结论
在进行雷氯必利诱导的应激 Rb-82 PET 时，心肌蠕动是一种常见现象，对 MBF 值有显著影响，尤其是在 RCA 区域。由于这可能会影响诊断准确性，因此对于可靠的定量分析，似乎需要进行心肌蠕动校正。
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