SPECT/CT心肌灌注显像左心室各壁段放射性分布  

Radioactivity distributing of left ventricle in myocardial perfusion SPECT/CT imaging

作　　者：黄克敏[1] 冯彦林[1] 梁伟棠[1] 刘德军[1] 杨明[1] 冼伟均[1] 李林[1] 冯叶霞 邓大浪 

机构地区：[1]佛山市第一人民医院核医学科,广东佛山528000

出　　处：《中国医学影像技术》2015年第11期1680-1684,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨SPECT/CT心肌灌注显像CT衰减校正(CTAC)和无衰减校正(NOAC)图像左心室各壁段的放射性分布特征。方法分析120例冠状动脉粥样硬化性心脏病低风险受检者99 Tcm-甲氧基异丁基异腈静息心肌灌注显像,均行CTAC。重建CTAC和NOAC图像。利用靶心图获得CTAC和NOAC图像左心室各壁段的放射性计数百分比,比较CTAC和NOAC图像左心室各壁段放射性计数和图像的差异,以及在不同性别和不同体质量指数(BMI)受检者间的差异。结果 NOAC图像示男性下后壁、间壁、前壁基底段的放射性计数百分比明显低于女性(t=-8.271、-4.2555、-3.168,P均<0.05),而前壁中段及前壁心尖部则明显高于女性(t=2.047、2.627,P均<0.05)。CTAC图像示左心室下后壁、间壁和侧壁的放射性计数百分比明显增加(t=21.077、8.635、2.623,P均<0.05),其中以男性下后壁最为显著,同时心尖部和前壁心尖部的放射性计数百分比明显减低(t=-16.421、-13.891,P均<0.001),其中以高BMI受检者的心尖部最为显著。NOAC图像示,女性前壁出现放射性稀疏的受检者明显多于男性[31.67%(19/60)和13.33%(8/60);χ2=5.783,P=0.016],男性下后壁出现放射性稀疏的受检者明显多于女性[78.33%(47/60)和15.00%(9/60);χ2=48.348,P<0.001];CTAC图像示分别有60.83%(73/120)、26.67%(32/120)、22.50%(27/120)的受检者出现下后壁、间壁、侧壁放射性分布增加,其中男性下后壁放射性分布增加的受检者明显多于女性[86.67%(52/60)和35.00%(21/60);χ2=33.611,P<0.001];同时28.33%(34/120)、61.67%(74/120)的受检者出现前壁、心尖部放射性分布减低。结论左心室各壁段的放射性分布在不同性别间存在显著差异,CTAC可明显改善左心室下后壁、间壁和侧壁的衰减伪影,其对男性的补偿作用明显优于女性。Objective To explore the radioactivity distributing of left ventricle in CT attenuation corrected（CTAC）and no attenuation corrected（NOAC）image of myocardial perfusion SPECT/CT.Methods The data of 120 patients were retrospectively analyzed,who had a low pretest likelihood of coronary artery disease after exercise rest ^99 Tc^m-methoxy isobutyl isouitril（99 Tcm-MIBI）myocardial perfusion SPECT and underwent CTAC on a SPECT/CT system.The CTAC and NOAC images were reconstructed for all patients.The counts of the left ventricle using myocardial Bull＇s-eye were measured.The image quality and semi-quantitative of the CTAC and NOAC and the difference of different sex and body mass index（BMI）were compared and analyzed.Results The counts of inferior-posterior,septal wall and anterior-basal region were significant lower（t=-8.271,-4.2555,-3.168,all P〈0.05）,and anterior-middle,anterior-apex region were significant higher（t=2.047,2.627,all P〈0.05）in man than those in woman on NOAC images.The counts of inferior-posterior,septal and lateral wall significant increased（t=21.077,8.635,2.623,all P〈0.05）in CTAC images compared to NOAC images expressly in the inferior-posterior wall of man,simultaneously the counts of apex wall and anterior-apex region significantly decreased（t=-16.421,-13.891,all P〈0.001）expressly in the apex wall of high BMI patients.The patients who had a anterior wall artificial were significant higher（31.67% [19/60]and 13.33% [8/60];χ^2=5.783,P=0.016）in woman than that in man,and the inferior-posterior wall artificials were significant higher（78.33% [47/60]and15.00% [9/60],χ^2=48.348,P〈0.001）in man than that in woman in NOAC images.The radioactivity distributing of inferior-posterior,septal and lateral wall significant increased for 60.83%（73/120）,26.67%（32/120）and 22.50%（27/120）respectively on CTAC images,and it was significant higher（86.67% [52/60]and 35.00% [21/60],χ^2=33.611,P〈0.001）in man than that in woman for inferior-posterior wall,an

关 键 词：心脏 体层摄影术 发射型计算机 单光子 衰减校正 伪影 

分 类 号：R817[医药卫生—影像医学与核医学] R541[医药卫生—放射医学]