X线衰减校正用于^(99m)Tc-N-NOET SPECT心肌灌注显像  

X-ray attenuation correction on ^(99m)Tc-N-NOET SPECT myocardial perfusion imaging

作　　者：卫华[1] 李思进[1] 刘建中[1] 武志芳[1] 李清[1] 胡光[1] 王进[1] 

机构地区：[1]山西医科大学第一医院核医学科,山西太原030001

出　　处：《中国医学影像技术》2010年第10期1953-1956,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价X线衰减校正(AC)对99mTc-N-NOETSPECT心肌灌注显像(MPI)伪影鉴别的临床应用价值。方法对54例可疑冠心病(CAD)患者的102例次MPI(负荷49例次,延迟或静息53例次)进行X线AC,比较AC前后的图像。其中有14例行冠状动脉造影检查(CAG)。结果 54例受检者中,31例正常,12例心肌可逆性灌注缺损,11例固定性缺损;AC后40例正常,12例可逆性缺损,2例固定性缺损。102例次MPI中,AC前,下后壁显像剂分布减低22例次(22/102,21.57%),AC后为4例次(4/102,3.92%),差异有统计学意义(χ2=14.282,P<0.05);14例CAG受检者中,8例正常,6例冠状动脉狭窄≥50%。CAG正常者AC前MPI显示6例正常,2例下后壁固定性缺损;AC后8例均正常;6例CAD者AC前MPI显示2例正常,1例前壁近心尖部可逆性缺损、下后壁固定性缺损,3例可逆性缺损,AC后,2例正常者MPI无变化,前壁近心尖部可逆性缺损、下后壁固定性缺损者,下后壁恢复正常,前壁近心尖部仍呈可逆性缺损,3例可逆性缺损者无变化。结论 X线AC能有效鉴别99mTc-N-NOETSPECT心肌灌注图像中的下后壁伪影,但可引起新伪影出现于心尖和前壁。Objective To observe the clinical application value of the X-ray attenuation correction （AC） on identifying artifacts on 99mTc-N-NOET SPECT myocardial perfusion imaging （MPI）. Methods One hundred and two MPI （49 stress MPI,53 delay or rest MPI） of 54 patients with suspected coronary artery disease （CAD）,who underwent sequential CT and myocardial SPECT imaging with 99mTc-N-NOET （1110 MBq） under an exercise protocol with SPECT/CT system,were compared before and after X-ray AC. Among 54 patients,14 underwent coronary angiography （CAG）. Results MPI of 31 patients were normal,while reversible defects and fixed defects were detected in 12 and 11 patients,respectively. After AC,MPI were normal in 40 patients,while reversible defects and fixed defects were detected in 12 and 2 patients,respectively. Before AC,perfusion reducing of inferior wall were showed in 22 man-times （22/102,21.57%） of MPI,whereas in 4 man-times （4/102,3.92%） after AC （χ2=14.282,P0.05）. Among 14 patients undergoing CAG,8 were normal,6 were found with CAD. Before AC,among the 8 CAG normal patients,MPI showed normal in 6,but detected inferior wall fixity defect in 2 patients,whereas after AC,the 8 patients were all normal. Before AC,among the 6 patients with CAD,MPI showed normal in 2,while reversible defect of anterior wall near the apex and fixed defect of inferior wall were found in 1 patient,reversible defects in 3 patients. After AC,2 normal MPI did not change,the patient with reversible defect of the anterior wall near the apex and fixed defect of inferior wall,inferior wall became normal,3 patients with reversible defects remained. Conclusion X-ray AC could be used to effectively identify artifacts under the posterior wall on MPI,but may cause new artifacts appearing in the apex and the anterior wall.

关 键 词：心肌灌注显像 体层摄影术 发射型计算机 单光子 衰减校正 

分 类 号：R817.4[医药卫生—影像医学与核医学]