不同校正方法对SPECT/CT心肌灌注显像结果的影响  

Effect of Different Correction Methods on SPECT/CT Myocardial Perfusion Imaging

作　　者：余丰文[1] 黄克敏[1] 冯彦林[1] 刘德军[1] 梁伟棠[1] 李林[1] YU Fengwen;HUANG Kemin;FENG Yanlin;LIU Dejun;LIANG Weitang;LI Lin(Department of Nuclear Medicine,the First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]广东省佛山市第一人民医院核医学科

出　　处：《中国医学影像学杂志》2020年第2期104-107,115,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨不同校正方法对SPECT/CT心肌灌注显像图像质量及半定量结果的影响。资料与方法回顾性分析60例99Tcm-甲氧基异丁基异腈(99Tcm-MIBI)运动负荷及静息心肌灌注显像患者,均进行CT衰减校正(CTAC)和双能窗散射校正(SC)。分别重建CTAC、SC、CTAC+SC以及无衰减校正和散射校正(NOC)图像。利用靶心图获得不同校正状态左心室各壁段的放射性计数百分比,以及运动负荷和静息图像灌注缺损半定量评分,比较不同校正状态下缺血心肌图像质量和半定量结果的差异。结果运动负荷显像左心室心尖部、下后壁、间壁、侧壁放射性计数百分比在不同校正方法间差异有统计学意义(P均<0.05)。负荷总体灌注不足率、负荷灌注总评分、静息-负荷差异总评分在不同校正方法间差异有统计学意义(P均<0.05),其在SC图像中明显高于NOC图像(P均<0.05),在CTAC+SC图像中明显高于CTAC图像(P均<0.01)。目测比较SC图像缺血心肌的稀疏程度明显高于NOC图像,CTAC+SC图像明显高于CTAC图像,其中以CTAC+SC图像对缺血部位的显示最为清晰。比较不同校正状态缺血心肌放射性分布评分,缺血程度为3分的比例在SC图像中明显高于NOC图像(X^2=4.953,P=0.026),在CTAC+SC图像中明显高于CTAC图像(X^2=7.216,P=0.007)。结论不同校正状态下左心室缺血心肌图像质量及半定量结果出现明显差异,SC能显著改善缺血心肌的显示,尤其在CTAC图像中更为显著。Purpose To investigate the effects of different correction methods on the image quality and semi-quantitative results of SPECT/CT myocardial perfusion imaging.Materials and Methods 99Tcm-methoxyisobutyl isonitrile(99Tcm-MIBI)exercise load and resting myocardial perfusion imaging in 60 patients were analyzed retrospectively,and subjected to CT attenuation correction(CTAC)and dual-energy window scatter correction(SC).The CTAC,SC,CTAC+SC and none of correction(NOC)images were reconstructed respectively.The percentage of radioactivity counts of left ventricular wall segments and the semi-quantitative perfusion defect scores of exercise load and resting images were obtained by myocardical Bulls-eye under different correction conditions.The differences of image quality and semi-quantitative results of ischemic myocardium were compared.Results The percentages of radioactivity counts in apex,posterior inferior wall,septal wall and lateral wall of left ventricle in exercise load imaging were significantly different among different correction methods(all P<0.05).There were significant differences in load total perfusion deficit,summed stress score and summed difference score among different correction methods(all P<0.05),which were significantly higher in SC than in NOC images(all P<0.05),and significantly higher in CTAC+SC than in CTAC images(all P<0.01).Visual comparison of ischemic myocardial images under different correction conditions showed that the sparseness of ischemic myocardium in SC images was significantly higher than that in NOC images,and that in CTAC+SC images was significantly higher than that in CTAC images.Among all the correction methods,CTAC+SC images showed the ischemic location most clearly.After comparison of radioactive distribution scores of ischemic myocardium in different correction states,the proportion of 3 points of ischemia severity in SC images was significantly higher than that in NOC images(X^2=4.953,P=0.026),and that in CTAC+SC images was significantly higher than that in CTAC images(X^2

关 键 词：心肌缺血 单光子发射计算机体层摄影术 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 心肌灌注显像 图像处理 计算机辅助 质量控制 

分 类 号：R445.6[医药卫生—影像医学与核医学]