Jeanguillaume C, Bochet J, Chehade F, Hindie E, Ajayan P M, Galle P
Service de Médecine Nucléaire Hôpital Henri Mondor, Creteil, France.
Nucl Med Commun. 1997 Dec;18(12):1161-70. doi: 10.1097/00006231-199712000-00008.
The aims of this study were to assess the effect of prone and supine positioning on 99Tc(m)-MIBI myocardial SPET images and the contribution of cardiac axis change. We compared 227 tomograms of patients imaged in the prone position with 227 tomograms of the same patients imaged in the supine position. For each tomographic session, the axis angle of the heart was recorded using an in-house program. The results showed a significant change in the cardiac axis angle of 9 degrees in the transaxial plane (P < 0.001). This change in the cardiac axis correlated with differences in cardiac wall activity (wall activity when the patient was imaged in the prone position minus wall activity when the patient was imaged in the supine position). Our results suggest that factors other than diaphragmatic movement and attenuation could account for the differences in wall activity observed when patients are imaged prone versus supine. Differences in the intensity of photon attenuation in the heart itself, depending on the cardiac axis, could be a contributing factor. Quantitation of the variation in wall activity leads us to suggest that 99Tc(m)-MIBI SPET should be performed in the prone position to allow better visualization of the inferior and the septal walls. The anterior and lateral walls are better studied in the supine position. Images acquired in both the prone and supine positions would allow the best assessment of all walls.
本研究的目的是评估俯卧位和仰卧位对99Tc（m）-甲氧基异丁基异腈心肌单光子发射计算机断层扫描（SPET）图像的影响以及心脏轴变化的作用。我们将227例患者俯卧位成像的断层扫描图像与同一批患者仰卧位成像的227例断层扫描图像进行了比较。对于每次断层扫描，使用内部程序记录心脏的轴角度。结果显示，在横断面平面上心脏轴角度有9度的显著变化（P<0.001）。心脏轴的这种变化与心脏壁活性的差异相关（患者俯卧位成像时的壁活性减去患者仰卧位成像时的壁活性）。我们的结果表明，除膈肌运动和衰减外的其他因素可能是导致患者俯卧位与仰卧位成像时观察到的壁活性差异的原因。心脏本身光子衰减强度的差异，取决于心脏轴，可能是一个促成因素。对壁活性变化的定量分析使我们建议，99Tc（m）-甲氧基异丁基异腈SPET应在俯卧位进行，以便更好地观察下壁和间隔壁。前壁和侧壁在仰卧位研究效果更好。在俯卧位和仰卧位获取的图像将有助于对所有壁进行最佳评估。
