Lu P, Liu X, Shi R, Mo L, Borer J S
Department of Nuclear Medicine, Cardiovascular Institute, Beijing, People's Republic of China.
J Nucl Cardiol. 1994 Nov-Dec;1(6):537-45. doi: 10.1007/BF02939977.
To compare tomographic and planar radionuclide ventriculography (RNVG) in assessing regional left ventricular (LV) function and predicting improvement in LV ejection fraction (LVEF) after operation in patients with LV aneurysm, 18 patients with aneurysm underwent both tomography and planar RNVG 1 month before and 3 weeks to 6 months after aneurysmectomy and coronary artery bypass grafting. All patients also underwent preoperative contrast angiography at catheterization. The percent shortening of the apical, anterior, lateral, inferior, and basal segments was calculated from tomographic long-axis and short-axis slices and corresponding planar images (anterior and 30- and 70-degree left anterior oblique views). No significant differences in anterior, apical, and lateral percent shortening were apparent before aneurysmectomy between tomographic and planar studies. However, preoperative basal percent shortening was 47% +/- 13% from tomographic and 28% +/- 14% from planar images (p < 0.001). Preoperative tomography generally agreed better with contrast angiographic results than did planar imaging. After aneurysmectomy, basal function improved to 57% +/- 12% (p < 0.01) by tomography. For all patients, LVEF increased from 29% +/- 8% before to 38% +/- 9% (p < 0.01) after aneurysmectomy. However, the greatest improvement (31% +/- 11% to 41% +/- 9%; p < 0.01) was in the 15 patients with greater than 30% basal shortening by tomography before aneurysmectomy; in contrast, no change of LVEF occurred in the three patients with lesser preoperative basal percent shortening. Moreover, greater than 30% basal percent shortening by tomography before aneurysmectomy identified the group most likely to have an increase in LVEF of 5% or more from before to after aneurysmectomy. Prediction of postoperative results was not possible from preoperative planar data. Thus in patients with LV aneurysm, tomographic RNVG appears to provide information that is different and more accurately predictive of results after aneurysmectomy than that available from planar imaging.
为比较断层扫描和平面放射性核素心室造影（RNVG）在评估左心室（LV）瘤患者左心室局部功能及预测术后左心室射血分数（LVEF）改善情况方面的差异，18例LV瘤患者在瘤体切除及冠状动脉搭桥术前1个月、术后3周～6个月分别接受了断层扫描和平面RNVG检查。所有患者术前均在导管室接受了对比血管造影检查。根据断层扫描的长轴和短轴切片以及相应的平面图像（前位和左前斜30度及70度视图）计算心尖、前壁、侧壁、下壁和基底段的缩短百分比。在瘤体切除术前，断层扫描和平面研究在前壁、心尖和侧壁缩短百分比方面无明显差异。然而，术前断层扫描的基底段缩短百分比为47%±13%，平面图像为28%±14%（p<0.001）。术前断层扫描与对比血管造影结果的总体一致性通常优于平面成像。瘤体切除术后，断层扫描显示基底段功能改善至57%±12%（p<0.01）。所有患者的LVEF从术前的29%±8%增加至术后的38%±9%（p<0.01）。然而，改善最明显的是术前断层扫描基底段缩短大于30%的15例患者（从31%±11%增至41%±9%；p<0.01）；相比之下，术前基底段缩短百分比较小的3例患者LVEF无变化。此外，术前断层扫描基底段缩短大于30%可识别出瘤体切除术后LVEF较术前增加5%或更多可能性最大的一组患者。术前平面数据无法预测术后结果。因此，对于LV瘤患者，断层扫描RNVG似乎能提供与平面成像不同且更准确预测瘤体切除术后结果的信息。
