利用CZT SPECT进行心脏^(99)Tc^(m)-MIBI/^(123)I-MIBG双核素显像的可行性研究  

A feasibility study of ^(99)Tc^(m)-MIBI/^(123)I-MIBG dual-isotope cardiac imaging using CZT SPECT

作　　者：张宗耀[1] 汪蕾[1] 张海龙 韩凯 方纬[1] Zhang Zongyao;Wang Lei;Zhang Hailong;Han Kai;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]北京协和医学院、中国医学科学院阜外医院核医学科,100037

出　　处：《中华核医学与分子影像杂志》2021年第9期536-539,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨利用碲-锌-镉(CZT)SPECT行^(99)Tc^(m)-甲氧基异丁基异腈(MIBI)/^(123)I-间碘苄胍(MIBG)双核素显像的可行性。方法利用A、B、C 3种心脏模型分别模拟正常心肌模型、^(99)Tc^(m)/^(123)I匹配心肌、^(99)Tc^(m)/^(123)I不匹配心肌,分别采集^(99)Tc^(m)单核素和^(99)Tc^(m)/^(123)I双核素显像图像并进行比较;对2018年9月至2020年6月间阜外医院19例患者[男9例,女10例;年龄(56±16)岁]先后行^(99)Tc^(m)-MIBI心肌灌注显像(MPI)和^(99)Tc^(m)-MIBI心肌灌注/^(123)I-MIBG心脏神经双核素显像,分别应用SPECT灌注定量(QPS)软件计算所有心肌节段的灌注百分比(PP%)和左心室整体心肌的灌注总评分(SRS),对单核素和双核素显像方法进行比较和相关分析(Pearson相关和Spearman秩相关)。心脏模型和患者图像均不进行物理校正。采用重复测量方差分析和Mann-Whitney U检验分析数据。结果心脏模型中,^(99)Tc^(m)单核素和^(99)Tc^(m)/^(123)I双核素图像差别很小,^(123)I对^(123)I-MIBG ^(99)Tc^(m)图像无明显影响。19例患者^(99)Tc^(m)-MIBI单核素显像和^(99)Tc^(m)-MIBI/^(123)I-MIBG双核素显像的心肌节段PP%分别为(69.2±14.5)%和(69.5±16.2)%(F=0.005,P=0.946),两者具有较高的相关性(r=0.845,P<0.01)。2种显像方法的SRS分别为2(1,13)和2(2,12)(z=-0.774,P=0.439),也具有较高的相关性(rs=0.975,P<0.01)。结论即使不行物理校正,较高能量的^(123)I对^(99)Tc^(m)图像的干扰对心脏图像判读也没有明显影响,心脏^(99)Tc^(m)-MIBI/^(123)I-MIBG双核素显像可行。Objective To study the feasibility of cardiac ^(99)Tc^(m)-methoxyisobutylisonitrile(MIBI)/^(123)I-metaiodobenzylguanidine(MIBG)dual-isotope imaging with cadmium-zinc-telluride(CZT)SPECT.Methods Using a heart phantom,^(99)Tc^(m)-MIBI single-isotope imaging and ^(99)Tc^(m)-MIBI/^(123)I-MIBG dual-isotope imaging were acquired separately.Model A,B,C represented normal heart,^(99)Tc^(m)/^(123)I matched myocardium,^(99)Tc^(m)/^(123)I mismatched myocardium,respectively.Nineteen patients(9 males,10 females;age(56±16)years)from September 2018 to June 2020 at Fuwai Hospital were enrolled to participate ^(99)Tc^(m)-MIBI myocardial perfusion imaging and myocardial perfusion/cardiac sympathetic imaging with ^(99)Tc^(m)-MIBI/^(123)I-MIBG dual-isotope.Perfusion percent(PP%)and summed rest score(SRS)for all myocardial segments were obtained using quantitative perfusion SPECT(QPS)software by analyzing myocardial perfusion images.Difference and relationship between PP%and SRS were analyzed(Pearson and Spearman correlation analyses).No physical correction was applied for both acquisitions.Analysis of variance for repeated measurement data and Mann-Whitney U test were used.Results There was no significant difference in myocardial perfusion images between ^(99)Tc^(m) single-isotope and ^(99)Tc^(m)/^(123)I dual-isotope imaging with the heart phantom.^(123)I did not significantly impact on ^(99)Tc^(m) images.For patients,PP%did not differ between ^(99)Tc^(m) single-isotope((69.2±14.5)%)and ^(99)Tc^(m)/^(123)I dual-isotope imaging((69.5±16.2)%;F=0.005,P=0.946)and correlated well(r=0.845,P<0.01).SRS for ^(99)Tc^(m) single-isotope was 2(1,13)and 2(2,12)for ^(99)Tc^(m)/^(123)I dual-isotope imaging(z=-0.774,P=0.439)and the correlation between the two acquisitions was excellent(rs=0.975,P<0.01).Conclusions Even without physical correction,cardiac images interpretation won′t be significantly influenced by the interference of ^(123)I with relatively higher energy on ^(99)Tc^(m) images.Cardiac ^(99)Tc^(m)-MIBI/^(123)I-MIBG dual-isotope ima

关 键 词：冠状动脉疾病 心肌灌注显像 体层摄影术 发射型计算机 单光子 99M锝甲氧基异丁基异腈 3-碘苄胍 

分 类 号：R817.4[医药卫生—影像医学与核医学]