Department of Radiological Technology, Fukuokaken Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, Fukuoka, 818-8516, Japan.
Division of Cardiovascular Medicine, Fukuokaken Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, Fukuoka, 818-8516, Japan.
Ann Nucl Med. 2021 Jun;35(6):735-743. doi: 10.1007/s12149-021-01615-6. Epub 2021 Apr 19.
Phase analysis is expected to improve the accuracy of myocardial ischemia diagnosis in conjunction with myocardial perfusion and wall motion imaging and quantification. Although previous studies have reported perfusion image disagreements in relation to radionuclides, a few reports have examined the influences of radionuclides on phase analysis. We evaluated the influences of different radionuclides on stress-induced left ventricular mechanical dyssynchrony by phase analysis using electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT) (MPS) imaging in patients with ischemic heart disease (IHD).
A total of 202 patients with suspected or known IHD were investigated retrospectively. All the patients underwent coronary arteriography and were subsequently classified into the following groups: 43 patients without any coronary lesion (0VD), 71 patients with single-vessel disease (1VD), 59 patients with two-vessel disease (2VD), and 29 patients with three-vessel disease (3VD). Both stress and rest gated-MPS were performed using Tc-methoxyisobutylisonitrile (MIBI)/tetrofosmin (TF) in 118 patients and with TlCl in 84 patients. Phase analysis was performed to obtain the peak phase, phase standard deviation (SD), and bandwidth. Finally, we investigated potential differences between the phase analysis indices and the respective radionuclides used.
The peak phase did not exhibit any significant differences in the numbers of affected branches in either Tc-MPS or Tl-MPS during stress or rest MPS. Furthermore, both the phase SD and bandwidth demonstrated a tendency to increase in patients with increased numbers of affected branches. A significant difference was observed in the stress MPS when Tc-MIBI/TF was used (p < 0.05), but no significant difference was observed in the stress MPS when TlCl was used. Both the phase SD and bandwidth of all patients in Tc-MPS during stress were significantly larger than those at rest (p < 0.05). Conversely, both the phase SD and bandwidth of all patients in Tl-MPS at stress was significantly smaller than that at rest (p < 0.05).
Phase analysis using Tc-MPS was considered to be useful for the detection of stress-induced left ventricular mechanical dyssynchrony, although it is necessary to be careful when using Tl-MPS.
与心肌灌注和壁运动成像和定量相结合，相位分析有望提高心肌缺血诊断的准确性。尽管先前的研究报告了与放射性核素有关的灌注图像不一致，但很少有研究检查放射性核素对相位分析的影响。我们使用心电图（ECG）门控心肌灌注单光子发射计算机断层扫描（MPS）成像评估了不同放射性核素对缺血性心脏病（IHD）患者应激诱导左心室机械不同步的影响。
回顾性调查了 202 例疑似或已知 IHD 患者。所有患者均行冠状动脉造影，随后分为以下组：无任何冠状动脉病变（0VD）患者 43 例、单支血管病变（1VD）患者 71 例、两支血管病变（2VD）患者 59 例、三支血管病变（3VD）患者 29 例。118 例患者使用 Tc-甲氧基异丁基异腈（MIBI）/四氟甲烷（TF）进行应激和静息门控-MPS，84 例患者使用 TlCl 进行应激和静息门控-MPS。进行相位分析以获得峰值相位、相位标准偏差（SD）和带宽。最后，我们研究了相位分析指标与各自放射性核素之间的潜在差异。
在应激或静息 MPS 期间，Tc-MPS 或 Tl-MPS 中受影响分支的数量对峰值相位均无显著差异。此外，随着受影响分支数量的增加，相位 SD 和带宽均表现出增加的趋势。当使用 Tc-MIBI/TF 时，应激 MPS 观察到显著差异（p<0.05），但当使用 TlCl 时，应激 MPS 观察到显著差异。Tc-MPS 中所有患者的应激相位 SD 和带宽均显著大于静息时（p<0.05）。相反，Tl-MPS 中所有患者的应激相位 SD 和带宽均显著小于静息时（p<0.05）。
使用 Tc-MPS 的相位分析被认为对检测应激诱导的左心室机械不同步有用，尽管在使用 Tl-MPS 时需要小心。
