Frais M A, Botvinick E H, Shosa D W, O'Connell W J, Scheinman M M, Hattner R S, Morady F
Am J Cardiol. 1982 Jul;50(1):95-105. doi: 10.1016/0002-9149(82)90014-5.
The phase image is a computer-derived functional image, based on the analysis of the time versus radioactivity curve in each pixel location of the multiple gated blood pool scintigram. Within the ventricular regions of interest, the phase angle is roughly equivalent to the time of onset of counts reduction or to the time of onset of ventricular contraction and is expressed in degrees from 0 to 360 degrees. A gray scale-coded image of such a regional phase angle, the phase image, can be looked on as a map of sequential contraction. This method was applied in 33 patients without severe contraction abnormality including 16 patients with normal conduction, 9 with right bundle branch block and 8 with left bundle branch block. In patients with normal conduction the pattern of phase angle distribution, representing the pattern of ventricular contraction, was homogeneous and symmetric in both the left and right ventricles. Analysis in this normal group indicated a slight but significant difference between the mean (+/- standard deviation) phase angle of the left ventricle (8.5 +/- 11.8 degrees) and that of the right ventricle (13.6 +/0 12.9 degrees, p = 0.01). There was a slight, but nonsignificant difference between mean intrapatient left and right ventricular phase angle onset (1.9 +/- 6.5 degrees). The mean phase angle of the right ventricle in patients with right bundle branch block (27.6 +/- 14.2 degrees) and of the left ventricle in those with left bundle branch block (21.9 +/- 14.0 degrees) was delayed compared with that in patients with normal conduction (p less than 0.05 for both). The mean intrapatient difference between left and right ventricular mean phase angles in patients with normal conduction (-5.2 +/- 6.8 degrees) was significantly different from that in patients with right (-21.8 +/- 10.3 degrees, p less than 0.001) or left (21.8 +/- 6.8 degrees, p less than 0.001) bundle branch block. The mean intrapatient difference between onset of left and right ventricular phase angles was also significantly different from normal in patients with right (-10.6 +/- 7.5 degrees, p less than 0.005) or left (18.7 +/- 8.3 degrees, p = 0.01) bundle branch block. Although phase imaging is not without artifactual error, this study demonstrates that the phase image can characterize familiar conduction abnormalities. It presents the potential for application as a general noninvasive tool in the investigation of the timing and sequence of ventricular contraction in patients with normal or abnormal ventricular activation.
相位图像是一种通过计算机生成的功能图像，它基于对多门控心血池闪烁图中每个像素位置的时间与放射性曲线的分析。在感兴趣的心室区域内，相位角大致相当于计数减少开始的时间或心室收缩开始的时间，以0至360度表示。这种区域相位角的灰度编码图像，即相位图像，可以看作是顺序收缩的图谱。该方法应用于33例无严重收缩异常的患者，其中包括16例传导正常者、9例右束支传导阻滞者和8例左束支传导阻滞者。在传导正常的患者中，代表心室收缩模式的相位角分布模式在左、右心室均是均匀且对称的。对这个正常组的分析表明，左心室的平均（±标准差）相位角（8.5±11.8度）与右心室的平均（±标准差）相位角（13.6±12.9度，p = 0.01）之间存在轻微但显著的差异。患者左、右心室内相位角起始的平均差异轻微，但无统计学意义（1.9±6.5度）。与传导正常的患者相比，右束支传导阻滞患者右心室的平均相位角（27.6±14.2度）和左束支传导阻滞患者左心室的平均相位角（21.9±14.0度）延迟（两者p均小于0.05）。传导正常患者左、右心室平均相位角之间的平均差异（-5.2±6.8度）与右束支传导阻滞患者（-21.8±10.3度，p小于0.001）或左束支传导阻滞患者（21.8±6.8度，p小于0.001）的平均差异有显著不同。右束支传导阻滞患者（-10.6±7.5度，p小于0.005）或左束支传导阻滞患者（18.7±8.3度，p = 0.01）左、右心室相位角起始的平均差异与正常情况相比也有显著不同。尽管相位成像并非没有人为误差，但本研究表明相位图像可以表征常见的传导异常。它显示了作为一种通用的非侵入性工具应用于研究心室激活正常或异常患者心室收缩的时间和顺序的潜力。
