新型碲-锌-镉单光子发射断层显像仪检测心力衰竭左心室机械收缩失同步研究  

Evaluation of left ventricular mechanical dyssynchrony in patients with heart failure using a novel Cadmium-Zinc-Telluride single photon emission computed tomography

作　　者：张宗耀[1] 吴大勇[1] 郭风[1] 杨志山 任俊灵 汪蕾[1] 何作祥[1] 方纬[1] Zhang Zongyao;Wu Dayong;Guo Feng;Yang Zhishan;Ren Junling;Wang Lei;He Zuoxiang;Fang Wei(Department of Nuclear Medicine,Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心心血管国家重点实验室阜外医院核医学科,100037 [2]山东吉威医疗制品有限公司

出　　处：《中华心律失常学杂志》2018年第6期477-481,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的应用碲-锌-镉单光子发射断层显像仪(CZT SPECT)进行门控心肌灌注显像(GMPI),对心力衰竭患者进行左心室机械收缩失同步评价,并与常规单光子发射计算机断层(SPECT)心肌灌注显像和正电子断层显像(PET)心肌代谢显像进行比较。方法入选中国医学科学院阜外医院2016年7月~10月连续35例心力衰竭患者,先后进行CZT SPECT、常规SPECT门控心肌灌注显像及门控PET心肌代谢显像,分别检测左心室相位带宽(BW)和相位标准差(SD)。结果CZTSPECTGMPI测得的BW(r=0.833,P<0.001)和SD(r=0.795,P<0.001)与常规SPECT的估测结果均有很好的相关性。CZT SPECTGMPI测得的BW(r=0.914,P<0.001)和SD(r=0.804,P<0.001)与PET的估测结果亦均有很好的相关性。Bland-Altman分析结果显示:CZT SPECT与PET测得的BW和SD均有较好的一致性。与CZT SPECT及PET测得结果比较,常规SPECT略低估BW和SD。结论CZTSPECT虽然采集时间明显缩短,但在检测心力衰竭患者左心室机械收缩失同步方面,与常规SPECT和PET均有较好的相关性和相对接近的一致性,因此有显著的临床应用价值。Objective The aim of this study was to evaluate left ventricular systolic asynchronization in patients with heart failure by gated myocardial perfusion imaging(GMPI)using Cadmium-Zinc-Telluride(CZT)single photon emission computed tomography(SPECT), and compare with conventional SPECT myocardial perfusion imaging(MRI) and positron emission tomography(PET)assessment. Methods Thirty-five consecutive patients with heart failure were recruited from July to October 2016 in Fuwai hospital.All patients underwent CZT SPECT GMPI, conventional SPECT GMPI, PET and cardiac MRI within 7 days.Bind width(BW)and standard deviation(SD)were calculated by three nuclear medicine imaging modalities. Results CZT SPECT GMPI showed good correlation respectively for BW(r=0.833, P<0.001)and SD(r=0.795, P<0.001)with conventional SPECT GMPI.CZT SPECT GMPI also showed a good correlation respectively for BW(r=0.914, P<0.001)and SD(r=0.804, P<0.001)with PET.Bland-Altman analysis revealed good agreement of BW and SD between CZT SPECT and PET.Bland-Altman analysis showed systematic underestimation of BW and SD with conventional SPECT GMPI compared with CZT SPECT and PET. Conclusion CZT SPECT GMPI with minimal acquisition time provides the left ventricular dyssynchrony parameters that correlated well and had good agreement with PET, and has the high value of clinical application in patients with heart failure.

关 键 词：心力衰竭 碲-锌-镉 单光子发射计算机断层显像 收缩失同步 

分 类 号：R541.6[医药卫生—心血管疾病]