X线衰减校正对提高心肌显像诊断冠心病准确性的价值  

Valuation of X-ray attenuation correction for diagnosing coronary heart disease by myocardial imaging

作　　者：胡硕[1] 雷萌[1] 罗湘建[2] 

机构地区：[1]中南大学湘雅医院核医学科 [2]卫生部肝胆肠外科研究中心,湖南长沙410008

出　　处：《中国现代医学杂志》2004年第16期100-103,共4页China Journal of Modern Medicine

摘　　要：目的探讨X线衰减校正是否能提高SPECT心肌灌注显像对冠心病诊断的准确性。方法制作模型模拟人体的心脏、组织、肝脏或肠道,40例患者,分别常规进行不带衰减校正的心肌灌注显像(普通心肌显像)和带X线断层衰减校正的心肌显像,用entegra软件对采集的原始图象进行重建处理,获不带衰减校正的心肌影像(NC)和带衰减校正的心肌影像(AC)。在各壁心肌划感兴趣区(ROI),计算平均计数值和相对计数值(R),分别比较这两种计数值在AC和NC之间的差别。结果心脏模型和40例受检者的AC各壁心肌ROI的平均计数值明显高于NC,t=4.17,P<0.001;对于不带干扰因素的心脏模型和受检者,AC和NC中各壁心肌的R值相接近;对于有组织衰减等干扰因素的受检者,其心肌的前壁或下壁,AC的R值明显高于NC,P<0.05;侧壁、间壁心肌其R值无显著性差别,P>0.05;而前壁近心尖部,AC的R值明显低于NC,P<0.05。结论X线衰减校正能有效校正因组织衰减或其他干扰因素造成的假阳性,对无干扰因素的心肌显像无明显影响,但对于前壁近心尖部,有校正过枉现象。Objective: To study whether X-ray attenuation correction can improve the veracity of diagnosing coronary heart disease by myocardial imaging. Methods: The models of people′s heart, tissue, liver and intestines were made. Model heart and forty patients were performed myocardial imaging by SPECT with or without X-ray attenuation correction respectively. The original images were restructured with 'entegra' soft and created myocardial images with X-ray attenuation correction (AC) and that without X-ray attenuation correction (NC). ROI was drawn on myocardial walls, calculate average radioactivity and comparative accounts (R) in each ROI, compare difference of the radioactivity between AC and NC. Results: The average accounts in ROI of myocardial walls in AC were distinctively higher than that in NC. t =4.17, P <0.001; For model heart without disturber, the R of myocardial walls between AC and NC were similar; For patients the R of AC in their front myocardial wall and underside wall were higher remarkably than that of NC. P <0.05; R in side wall and middle wall were not observably different between AC and NC. P >0.05; R of front wall near heart tine in AC was evidently lower than that of NC. P <0.05. Conclusions: X-ray attenuation correction does not influence myocardial imaging for normal myocardium. It can correct fake masculine made by tissues or other disturbing factors. It adjusts excess ively in front wall near heart tine.

关 键 词：衰减 校正 心肌 放射性核素显像 冠心病 

分 类 号：R814.4[医药卫生—影像医学与核医学]