CT衰减校正对IQ-SPECT/CT和LEHR-SPECT/ CT心肌灌注显像的影响  

Effect of CT attenuation correction on IQ-SPECT/CT and LEHR-SPECT/CT myocardial perfusion imaging

作　　者：卫华[1] 薛及弟 武志芳[1] 张磊[1] 胡光[1] 王进[1] Wei Hua;Xue Jidi;Wu Zhifang;Zhang Lei;Hu Guang;Wang Jin(Department of Nuclear Medicine,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院核医学科,太原030001

出　　处：《国际放射医学核医学杂志》2020年第7期405-410,共6页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：山西省应用基础研究项目(201701D121179)。

摘　　要：目的探讨CT衰减校正(CTAC)对智能(IQ)-SPECT/CT和低能高分辨率(LEHR)- SPECT/CT心肌血流灌注显像(MPI)图像的影响。方法收集2018年5月至10月在山西医科大学第一医院行静息心肌灌注显像(MPI)的31例确诊或者可疑的冠心病患者,其中男性21例、女性10例,年龄(49.4±12.01)岁。所有患者同日分别行IQ-SPECT/CT+CTAC及LEHR-SPECT/CT+ CTAC。视觉分析IQ-SPECT/CT CTAC前后图像及手动配位后图像、LEHR-SPECT/CT CTAC前后断层图像;同时比较左心室各个室壁(心尖、前壁、侧壁、间壁、下壁)IQ-SPECT/CT和LEHR-SPECT/CT CTAC前后与重新配位后的放射性摄取值(%)。两组间比较采用配对t检验,率的比较采用卡方检验,一致性分析采用Kappa检验。结果①视觉分析:IQ-SPECT/CT与LEHR-SPECT/CT CTAC前图像比较,具有很高的一致性(Kappa值=0.795,P<0.001)。IQ-SPECT/CT CTAC后心肌节段出现放射性分布明显稀疏的比例为77%(24/31),远高于LEHR-SPECT/CT CTAC后的23%(7/31),差异有统计学意义(χ^2=16.52,P<0.001)。将MPI与CT图像手动重新配位后,IQ-SPECT/CT左心室心尖的放射性分布为16%(5/31),与LEHR-SPECT/CT的23%(7/31)相比,差异无统计学意义(χ^2=0.103,P=0.748)。②放射性摄取值(%):IQ-SPECT/CT CTAC前后比较,左心室心尖[(65.71±25.69)%对(58.68±20.39)%]、前壁[(204.23±43.24)%对(184.66±41.22)%]及间壁[(316.19±47.43)%对(270.03±65.33)%]的放射性摄取值明显降低,且差异均有统计学意义(t=4.014、4.232、5.473,均P<0.05);LEHR-SPECT/CT CTAC前后比较,左心室前壁[(204.68±41.14)%对(211.81±35.04)%]、间壁[(319.13±44.90)%对(350.87± 44.24)%]及下壁[(185.48±31.06)%对(228.67±29.45)%]的放射性摄取值显著增高,且差异均有统计学意义(t=-2.471,P =0.019;t=-5.968,P<0.001;t=-11.311,P<0.001)。IQ-SPECT/CT CTAC配位后与IQ-SPECT/CT CTAC前比较,左心室前壁[(212.06±33.59)%对(204.23±43.24)%]、侧壁[(372.84±39.37)%对(355.81±46.79)%]、下壁[(219.13±25.10)%对(191.58±33.06)%]和间壁[(3Objective To evaluate the impact of CT attenuation correction(CTAC)on intelligence quotient(IQ)-SPECT/CT and low energy high resolution(LEHR)-SPECT/CT myocardial perfusion imaging(MPI).Methods Thirty-one patients(21 males and 10 females,aged 49.4±12.01 years)with confirmed or suspected coronary heart disease were subjected to resting MPI from May 2018 to Octorber 2018 in the First Hospital of Shanxi Medical University.All patients were subjected to IQ-SPECT/CT+CTAC and LEHR-SPECT/CT+CTAC on the same day.The visual analysis and myocardial uptake of five myocardial segments(apical,anterior,lateral,inferior,and septal walls)were compared before and after IQ-SPECT/CT CTAC and after manual coordination,as well as before and after LEHR-SPECT/CT CTAC.Paired t test was used for comparison between the two groups.Chi-square test was used to compare the rate.Kappa test was used for consistency analysis.Results(1)Visual analysis results were as follows.The IQ group was compared with the LEHR group without CTAC.Two nuclear medicine physicians were double blind and had high agreement(Kappa value=0.795,P<0.001).The sparse rate of myocardial segments of the IQ group was 77%(24/31),which was much higher than that of the LEHR group by 23%(7/31)(χ^2=16.52,P<0.001).Owing to the high sparse rate myocardial segments of IQ,the original image and manual reregistration the MPI and CT images were analyzed.After re-coordination,the distribution of apical in the IQ group was found to be sparse(16%,5/31),and the difference between the LEHR group(23%,7/31)was not statistically significant(χ^2=0.103,P=0.748).(2)Results of myocardial uptake were as follows.Compared with the previous IQ-CTAC,the myocardial uptake values of the apical wall[(65.71±25.69)%vs.(58.68±20.39)%],anterior wall[(204.23±43.24)%vs.(184.66±41.22)%],and septal wall[(316.19±47.43)%vs.(270.03±65.33)%]significantly decreased after CTAC(t=4.014,4.232,and 5.473,respectively;all P<0.05).Meanwhile,myocardial uptake increased in anterior wall[(204.68±41.14)%vs.(211.81±35.0

关 键 词：体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 衰减校正 心肌灌注显像 

分 类 号：R541.4[医药卫生—心血管疾病] R817.4[医药卫生—内科学]