门控心肌SPECT显像三种定量分析软件测定左心室容积和射血分数的比较  

Quantification of left ventricular volumes and ejection fraction from gated ^(99)Tc^m-MIBI SPECT:a comparison of QGS,ECToolbox and 4D-MSPECT

作　　者：杜艳[1] 杨敏福[1] 田月琴[1] 方纬[1] 沈锐[1] 何作祥[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院核医学科,北京100037

出　　处：《中华核医学杂志》2007年第3期161-164,共4页Chinese Journal of Nuclear Medicine

基　　金：北京市首都医学发展科研基金(2003-2-433)

摘　　要：目的研究定量门控心肌断层显像(QGS)、爱莫瑞心脏工具箱(ECToolbox)和四维模型心肌断层显像(4D-MSPECT)3种定量分析软件所测左心室射血分数(LVEF)、舒张末期容积(EDV)和收缩末期容积(ESV)的相关性以及与左心室造影之间的相关性。方法临床疑诊或确诊冠心病患者212例均行^(99)Tc^m-MIBI 门控心肌 SPECT 显像,并分别以 QGS、ECToolbox 和4D-MSPECT 软件处理得 LVEF_1、EDV_1、ESV_1。其中106例患者行左心室造影,分别测得 LVEF_2、EDV_2、ESV_2。比较3种软件之间及其与左心室造影之间的相关性。结果 3种软件所测 LVEF_1、EDV_1、ESV_1的相关性好,所测 LVEF_1值的 r 值为0.89～0.91(P 均<0.001),EDV_1、ESV_1值的 r 值为0.97～0.98(P 均<0.001)。对于 LVEF_1和 EDV_1,QGS、ECToolbox、4D-MSPECT 所测值间的差异具有统计学意义(P<0.001)。QGS所测值[LVEF_1:(59.2±11.4)%、EDV_1:(88.8±35.5)ml]低于4D-MSPECT 所测值[LVEF_1:(64.2±12.6)%、EDV_1:(98.1±39.5)mI],4D-MSPECT 所测值又低于 ECToolbox 所测值[LVEF_1:(68.3±12.8)%、EDV_1:(108.2±39.0)ml];而对于 ESV_1,QGS[(39.0±27.0)m1]、ECToolbox[(37.9±31.4)ml]与4D-MSPECT[(38.7±31.3)ml]所测值之间差异无统计学意义(P=0.92)。门控心肌SPECT 显像与左心室造影所测 LVEF_2、EDV_2、ESV_2的相关性好,r 值分别为0.70～0.80,0.57～0.61和0.87～0.89(P 均<0.001)。结论 3种门控 SPECT 定量分析软件所测值之间及与左心室造影的相关性均较好。Objective The three commercially available gated SPECT software： quantitative gated SPECT （QGS）, emory cardiac toolbox （ECToolbox）, and four-dimensional model SPECT （4D-MSPECT） were compared in the calculation of left ventricular ejection fraction （LVEF）, end-diastolic volume （EDV） and end-systolic volume （ESV）. Methods Two hundred and twelve patients with suspected or known coronary artery disease were examined using gated 99^Tc^m-MIBI SPECT. QGS,ECToolbox and 4D-MSPECT were used for the estimation of LVEF, EDV, ESV. One hundred and six of the 212 patients underwent left ventriculography within one month of SPECT. Results Correlation between the methods were excellent for LVEF, EDV and ESV, the correlation coefficients among the 3 software were 0.89 -0.91 for LVEF（P 〈 0. 001 ）, and 0.97 - 0.98 for EDV and ESV （ P 〈 0. 001 ）. For LVEF and EDV, significant differences were noticed among the 3 methods （P 〈 0.001 ）. The values of 4D-MSPECT [ LVEF： （ 64.2 ± 12.6）%, EDV ： （98.1 ± 39.5 ） ml ] were significantly lower than that of ECToolbox [ LVEF ： （ 68.3 ±12.8 ） %, EDV： （108.2±39.0） ml]; likewise, the values of QGS [LVEF： （59.2±11.4）%, EDV： （88.8±35. 5） ml] were lower than that of 4D-MSPECT. For ESV, there was no significant differences among QGS [ （39.0 ± 27.0） ml ], ECToolbox [ （37.9 ±31.4） ml ] and 4D-MSPECT [ （ 38.7 ± 31.3） ml, P = 0.92 ]. Good correlation existed between results of gated SPECT and left ventriculography for LVEF, EDV and ESV, r =0.70 ±0.80 for LVEF（P 〈0.001 ）, 0.57 -0.61 for EDV（P 〈0.001 ） and 0.87 -0.89 for ESV （ P 〈 0.001 ）. Conclusion All 3 programs showed good correlation among one another, and between ventriculography.

关 键 词：门控血池显像 体层摄影术 发射型计算机 单光子 软件 对比研究 

分 类 号：R817[医药卫生—影像医学与核医学]