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动力学模型和衰减校正对碲锌镉单光子发射计算机断层扫描(CZT SPECT)衍生的心肌血流和储备的影响:与有创血管造影数据的相关性

The Influence of Kinetic Models and Attenuation Correction on Cadmium-Zinc-Telluride Single-Photon Emission Computed Tomography (CZT SPECT)-Derived Myocardial Blood Flow and Reserve: Correlation with Invasive Angiography Data.

作者信息

Mochula Andrey, Maltseva Alina, Kopeva Kristina, Grakova Elena, Mochula Olga, Zavadovsky Konstantin

机构信息

Nuclear Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia.

Department of Myocardial Pathology, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia.

出版信息

J Clin Med. 2024 Feb 23;13(5):1271. doi: 10.3390/jcm13051271.

Abstract

(1) : The objective of this study was to determine the optimal post-processing model for dynamic cadmium-zinc-telluride single-photon emission computed tomography (CZT-SPECT). (2) : A total of 235 patients who underwent diagnostic invasive coronary angiography within three months of the SPECT and those who had coronary computed tomography angiography (CCTA) before SPECT (within 3 months) were enrolled in this study. Each SPECT study was processed to obtain global and regional stress myocardial blood flow (sMBF), rest-MBF (rMBF), myocardial flow reserve (MFR) and flow difference (FD) estimates obtained with 1-tissue-compartment (1TCM) and net retention (NR) modes, both with and without attenuation correction. (3) : The use of AC led to significantly higher sMBF, rMBF and DF values obtained by 1TCM compared those values derived by 1TCM with NAC; the lowest values of stress MBF and rest MBF were obtained by 1TCM_NAC. The resting flow, MFR and DF were significantly ( < 0.005) higher in the AC model than in NAC. All quantitative variables were significantly ( < 0.05) higher in NR_NAC than in the 1TC_NAC model. Finally, sMBF, rMBF and FD showed significantly ( < 0.05) higher values by using 1TMC_AC compared to NR_AC. (4) : We suggested that 1-compartment and net retention models correctly reflect coronary microcirculation and can be used for clinical practice for evaluating quantitative myocardial perfusion by dynamic SPECT. Attenuation correction is an important step in post-processing dynamic SPECT data, which increases the consistency and diagnostic accuracy of models.

摘要

(1):本研究的目的是确定动态碲镉锌单光子发射计算机断层扫描(CZT-SPECT)的最佳后处理模型。(2):本研究纳入了235例在SPECT检查后三个月内接受诊断性有创冠状动脉造影的患者,以及那些在SPECT检查前(三个月内)进行过冠状动脉计算机断层扫描血管造影(CCTA)的患者。对每项SPECT研究进行处理,以获得通过单组织室(1TCM)和净滞留(NR)模式在有和没有衰减校正的情况下获得的整体和局部应激心肌血流量(sMBF)、静息心肌血流量(rMBF)、心肌血流储备(MFR)和血流差异(FD)估计值。(3):与1TCM未进行衰减校正(NAC)相比,使用衰减校正(AC)导致1TCM获得的sMBF、rMBF和DF值显著更高;应激心肌血流量和静息心肌血流量的最低值是通过1TCM_NAC获得的。AC模型中的静息血流量、MFR和DF显著高于NAC(<0.005)。所有定量变量在NR_NAC中均显著高于1TC_NAC模型(<0.05)。最后,与NR_AC相比,使用1TMC_AC时sMBF、rMBF和FD显示出显著更高的值(<0.05)。(4):我们建议单室和净滞留模型能够正确反映冠状动脉微循环,可用于临床实践中通过动态SPECT评估定量心肌灌注。衰减校正是动态SPECT数据后处理中的重要步骤,可提高模型的一致性和诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6892/10932033/d62395a3e8f1/jcm-13-01271-g001.jpg

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