Department of Nuclear Medicine, TEDA International Cardiovascular Hospital, Tianjin, China.
Medicine (Baltimore). 2024 Sep 27;103(39):e39821. doi: 10.1097/MD.0000000000039821.
We compared and analyzed the consistency and repeatability of left and right ventricular ((LV/RV) functions obtained by gated-equilibrium radionuclide ventriculography (ERNV) with cadmium-zinc-telluride single-photon emission computed tomography (CZT-SPECT) and conventional SPECT (C-SPECT) with sodium iodide crystal detectors. Seventy-seven patients were included in the retrospective study. Both C-SPECT and CZT-SPECT imaging were performed on the same day. Correlations and differences in LV/RV ejection fraction (LVEF and RVEF), peak ejection rate (PER), and peak filling rate (PFR) were compared between the 2 models. Cardiac magnetic resonance (CMR) was partially used as the gold standard, and ultrasound results were included for comparative analysis. Interobserver reproducibility of each parameter obtained by the 2 cameras was compared. Between the 2 cameras, there were no significant difference in LVEF, LVPER, LVPFR, and RVPER (P > .05) and there were in RVEF and RVPFR (P < .05 or .001). The correlations (R value) were 0.831 (LVEF, excellent), 0.619 (RVEF, good), 0.672 (LVPER, good), 0.700 (LVPFR, good), 0.463 (RVPER, normal), and 0.253 (RVPFR, poor). There were no significant difference between CMR and CZT-SPECT in LVEF (P > .05) while there were between CMR and both C-SPECT and ultrasound (P < .05). The correlations were all good (R = 0.660, 0.658, and 0.695). There were no significant difference between CMR and both C-SPECT and CZT-SPET in RVEF (P > .05) and the correlations were good (R = 0.771 and 0.745). For repeatability, the intraclass correlation coefficient of RVPFR by C-SPECT was good (intraclass correlation coefficient = 0.698) and excellent for the rest of the groups (0.823-0.989). The repeatability of LVEF and RVEF was better for CZT-SPECT than for C-SPECT. The repeatability of PER was better for both cameras than PFR. CZT-SPECT tomographic ERNV correlated well with C-SPECT planar ERNV in evaluation of biventricular systolic function and LV diastolic function. Compared with the "gold standard" CMR, both models had good correlation in measuring LV/RVEF. CZT-SPECT had better inter-group reproducibility than C-SPECT. The accuracy of RV diastolic function need further study. CZT-SPECT tomographic ERNV will play an important and unique role in the clinical application of accurate evaluation of biventricular function in the future.
我们比较和分析了门控平衡放射性核素心室显像（ERNV）与碲锌镉单光子发射计算机断层扫描（CZT-SPECT）和传统单光子发射计算机断层扫描（C-SPECT）与碘化钠晶体探测器获得的左、右心室（LV/RV）功能的一致性和可重复性。77 例患者被纳入回顾性研究。同一天进行 C-SPECT 和 CZT-SPECT 成像。比较两种模型的 LV/RV 射血分数（LVEF 和 RVEF）、峰值射血率（PER）和峰值充盈率（PFR）的差异和相关性。心脏磁共振（CMR）部分用作金标准，并纳入超声结果进行比较分析。比较两种相机获得的每个参数的观察者间可重复性。两种相机之间，LVEF、LVPER、LVPFR 和 RVPER 无显著差异（P>.05），而 RVEF 和 RVPFR 有显著差异（P<.05 或.001）。相关性（R 值）分别为 0.831（LVEF，优秀）、0.619（RVEF，良好）、0.672（LVPER，良好）、0.700（LVPFR，良好）、0.463（RVPER，正常）和 0.253（RVPFR，较差）。CMR 与 CZT-SPECT 在 LVEF 方面无显著差异（P>.05），而与 C-SPECT 和超声均有显著差异（P<.05）。相关性均良好（R=0.660、0.658 和 0.695）。CMR 与 C-SPECT 和 CZT-SPET 在 RVEF 方面无显著差异（P>.05），相关性良好（R=0.771 和 0.745）。在重复性方面，C-SPECT 的 RVPFR 内部一致性系数良好（内部一致性系数=0.698），其余各组均为优秀（0.823-0.989）。CZT-SPECT 的 LVEF 和 RVEF 重复性优于 C-SPECT。PER 的重复性好于 PFR。CZT-SPECT 断层 ERNV 与 C-SPECT 平面 ERNV 在评价双心室收缩功能和左心室舒张功能方面相关性良好。与“金标准”CMR 相比，两种模型在测量 LV/RVEF 方面均具有良好的相关性。CZT-SPECT 的组间可重复性优于 C-SPECT。右心室舒张功能的准确性需要进一步研究。CZT-SPECT 断层 ERNV 将在未来对双心室功能的准确评估的临床应用中发挥重要而独特的作用。
