Anagnostopoulos C, Gunning M G, Pennell D J, Laney R, Proukakis H, Underwood S R
Royal Brompton Hospital, London, UK.
Eur J Nucl Med. 1996 Aug;23(8):909-16. doi: 10.1007/BF01084364.
We have validated ECG-gated emission tomography using technetium-99m methoxyisobutylisonitrile for the assessment of regional ventricular function by comparing it with cine magnetic resonance imaging (MRI). Gated tomography was performed at rest in 24 patients referred for myocardial perfusion imaging [17 males and seven females with a mean age of 58 years, nine of whom had had a previous myocardial infarction (MI)]. Scores were assigned to each of nine myocardial segments for wall motion and for thickening. Cine MRI was analysed in an identical fashion. Four out of 216 (2%) segments were uninterpretable by gated tomography because of inadequate tracer uptake. In eight patients without coronary artery disease (CAD), wall motion and thickening were normal by both methods. Gated tomography showed abnormal wall motion or thickening in all patients with previous MI and in five of seven patients with CAD but no prior MI. Association between wall motion and thickening was good (rs=0. 86). Overall, there was good agreement between gated tomography and MRI for both wall motion (178/212 segments, kappa=0.66) and wall thickening (184/212 segments, kappa=0.69). In segments with severely reduced perfusion, however, there was poorer agreement (kappa=0.31). Interobserver and intraobserver agreement was high (kappa from 0.61 to 0.78). Thus, in patients investigated for CAD, there is good overall agreement between gated tomography and MRI but the agreement is lower in segments with severe perfusion defects.
我们通过将锝-99m甲氧基异丁基异腈门控发射断层扫描与电影磁共振成像（MRI）进行比较，验证了其用于评估局部心室功能的有效性。对24例因心肌灌注成像就诊的患者进行了静息门控断层扫描[17例男性和7例女性，平均年龄58岁，其中9例曾有过心肌梗死（MI）]。对九个心肌节段的壁运动和增厚情况分别进行评分。以相同方式分析电影MRI。由于示踪剂摄取不足，216个节段中有4个（2%）无法通过门控断层扫描进行解读。在8例无冠状动脉疾病（CAD）的患者中，两种方法测得的壁运动和增厚情况均正常。门控断层扫描显示，所有既往有MI的患者以及7例有CAD但既往无MI的患者中的5例，均存在壁运动或增厚异常。壁运动与增厚之间的相关性良好（rs = 0.86）。总体而言，门控断层扫描与MRI在壁运动（178/212个节段，kappa = 0.66）和壁增厚（184/212个节段，kappa = 0.69）方面均具有良好的一致性。然而，在灌注严重降低的节段中，一致性较差（kappa = 0.31）。观察者间和观察者内的一致性较高（kappa为0.61至0.78）。因此，在因CAD接受检查的患者中，门控断层扫描与MRI总体一致性良好，但在存在严重灌注缺损的节段中一致性较低。
