在既往心肌梗死患者中，与锝-甲氧基异丁基异腈门控单光子发射计算机断层扫描（SPECT）相比，氟代脱氧葡萄糖（F-FDG）门控正电子发射断层扫描（PET）用于评估左心室不同步的可行性。
The feasibility of F-FDG gated positron emission tomography (PET) for left ventricular dyssynchrony assessment in comparison with Tc-MIBI gated single-photon emission computed tomography (SPECT) among patients with prior myocardial infarction.
作者信息
Yao Yong, Wei Tian-Jing, Wang Da-Wei
机构信息
Department of Nuclear Medicine, the Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, China.
Clinical Medicine Postdoctoral Research Station, The First Affiliated Hospital, Jinan University, Guangzhou, China.
出版信息
Quant Imaging Med Surg. 2022 Apr;12(4):2454-2463. doi: 10.21037/qims-21-822.
BACKGROUND
Phase analysis by Tc-MIBI gated single-photon emission computed tomography (GSPECT) has been considered to be an adequate method in the validation of left ventricular (LV) dyssynchrony. Compared with GSPECT, prior myocardial infarction patients with myocardial perfusion defects but myocardial viability usually show preserved uptake of F-FDG, and extensive myocardium is detected by F-FDG gated positron emission tomography (GPET). Thus, theoretically, it should be more accurate. The aim of this study was to investigate the feasibility of GPET for LV dyssynchrony assessment in comparison with GSPECT among infarction patients.
METHODS
A total of 146 patients with infarction underwent 2 consecutive days of GSPECT and GPET examinations. Quantitative gated SPECT-derived LV phase analysis was applied to GPET and GSPECT data to assess the presence of LV dyssynchrony via histogram bandwidth (BW) and phase standard deviation (SD). The correlation and agreement of BW and SD between GSPECT and GPET were examined. Factors (i.e., total perfusion defect, scar and mismatch) related to the discrepancies of LV dyssynchrony (i.e., BW and SD) in GPET and GSPECT were assessed by univariate and multivariate regression analysis.
RESULTS
A moderate correlation between GPET and GSPECT was found in the measurements of BW (r=0.554) and SD (r=0.537). Bland-Altman analysis revealed that GPET overestimated both BW and SD (20.5° and 9.5°, respectively). In addition, the BW and SD measured by GPET were still overestimated after subgroup analysis. Between GPET and GSPECT, multivariate regression analysis revealed that total perfusion defects were related to the difference in BW measurement (P<0.001), and mismatch was associated with the difference in SD measurement (P<0.01).
CONCLUSIONS
In patients with infarction, GPET moderately correlated with GSPECT in assessing LV dyssynchrony. GPET overestimated both BW and SD, so these analyses should not be interchangeable in individual patients.
背景
通过锝-甲氧基异丁基异腈门控单光子发射计算机断层扫描（GSPECT）进行的相位分析被认为是验证左心室（LV）不同步的一种适当方法。与GSPECT相比，既往有心肌梗死且存在心肌灌注缺损但心肌存活的患者通常表现为氟代脱氧葡萄糖（F-FDG）摄取保留，并且通过F-FDG门控正电子发射断层扫描（GPET）可检测到广泛的心肌。因此，从理论上讲，它应该更准确。本研究的目的是在梗死患者中比较GPET与GSPECT评估LV不同步的可行性。
方法
总共146例梗死患者连续两天接受了GSPECT和GPET检查。将定量门控SPECT衍生的LV相位分析应用于GPET和GSPECT数据，通过直方图带宽（BW）和相位标准差（SD）评估LV不同步的存在情况。检查了GSPECT和GPET之间BW和SD的相关性及一致性。通过单因素和多因素回归分析评估与GPET和GSPECT中LV不同步差异（即BW和SD）相关的因素（即总灌注缺损、瘢痕和不匹配）。
结果
在BW（r = 0.554）和SD（r = 0.537）测量中，发现GPET与GSPECT之间存在中等程度的相关性。Bland-Altman分析显示，GPET高估了BW和SD（分别高估20.5°和9.5°）。此外，亚组分析后，GPET测量的BW和SD仍然被高估。在GPET和GSPECT之间，多因素回归分析显示，总灌注缺损与BW测量差异相关（P < 0.001），不匹配与SD测量差异相关（P < 0.01）。
结论
在梗死患者中，GPET与GSPECT在评估LV不同步方面具有中等相关性。GPET高估了BW和SD，因此在个体患者中这些分析不应相互替代。
Zotero 插件