IQ-SPECT与配置低能高分辨准直器SPECT的临床应用比较  

Comparison of IQ-SPECT and low energy high-resolution collimator SPECT in clinical application

作　　者：韩凯 张海龙 张宗耀[1] 孙晓昕[1] 汪蕾[1] 方纬[1] Han Kai;Zhang Hailong;Zhang Zongyao;Sun Xiaoxin;Wang Lei;Fang Wei(Department of Nuclear Medicine,Fuwai Hospital,Chinese Academy of Medical Sciences and 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,北京100037

出　　处：《中华核医学与分子影像杂志》2022年第6期357-362,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的:探讨核素心肌灌注显像中,应用IQ-SPECT和常规配置低能高分辨(LEHR)准直器SPECT(LEHR-SPECT)在测定心功能和血流灌注参数方面的差异,以及经过散射校正(SC)和CT衰减校正(AC)后的变化。方法:回顾性分析2020年5月至2020年9月期间于阜外医院行SPECT心肌灌注显像的患者80例[男58例、女22例,年龄(57±10)岁]。根据二维超声心动图测得的体表面积标准化的左心室舒张末期内直径将患者分为2组:A组(34例),有明显的左心室增大;B组(46例),左心室未见明显增大。所有患者均行LEHR-SPECT和IQ-SPECT门控静息心肌灌注显像,测定左心室舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、静息总积分(SRS)和心肌总灌注缺损程度(TPD),并比较2种方法之间及SC和AC前后上述参数的变化。采用配对t检验和Wilcoxon符号秩检验分析数据,采用Pearson相关或Spearman秩相关分析和Bland-Altman评价2种方法的相关性和一致性。结果:对于A组患者,经过SC和AC后,IQ-SPECT测得的EDV、EF和SRS显著低于LEHR-SPECT[EDV:(257±137)和(276±154)ml,EF:(21±11)%和(26±13)%,SRS:17(6,25)和18(8,28);t值:-2.63、-7.46,z=-2.14,均P<0.05];2种方法测得的各项参数均有较好的相关性(r值:0.965、0.969、0.967,r_(s)值:0.920、0.960,均P<0.001)和一致性。对于B组患者,经过SC和AC后,IQ-SPECT测得的EDV和EF显著低于LEHR-SPECT[EDV:(96±40)和(107±39)ml,EF:(46±15)%和(54±16)%;t值:-6.23、-10.71,P值:0.001、0.001];IQ-SPECT经过SC和AC后,SRS和TPD均较未校正显著降低[SRS:2(1,4)和5(3,11),TPD:3%(1%,5%)和7%(3%,12%);z值:-4.11、-4.16,均P<0.001];2种方法测得的各项参数也有较好的相关性(r值:0.956、0.978、0.958,r_(s)值:0.926、0.944,均P<0.001)和一致性。结论:IQ-SPECT与LEHR-SPECT测得的心功能和血流灌注指标有较好的相关性和一致性,IQ-SPECT可有效缩短采集时间,在临床应用方面更具有优势。Objective To investigate differences in cardiac function and perfusion parameters measured by IQ-SPECT and low energy high-resolution(LEHR)-SPECT,as well as effects of scattering correction(SC)and CT attenuation correction(AC)on myocardial perfusion imaging.Methods From May 2020 to September 2020,80 patients(58 males,22 females,age(57±10)years)who underwent SPECT myocardial perfusion imaging were retrospectively enrolled in Fuwai Hospital.According to the standardized left ventricular end-diastolic diameter of body surface measured by two-dimensional echocardiography,patients were divided into 2 groups:A group(n=34)with significantly enlarged left ventricle and B group(n=46)with no significant enlargement of left ventricle.LEHR-SPECT and IQ-SPECT gated myocardial perfusion imaging were performed in all patients.Left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),ejection fraction(EF),summed rest score(SRS)and total perfusion defect(TPD)were measured.Parameters measured by two methods and differences before and after SC and AC were compared by using paired t test and Wilcoxon signed rank test.The correlation was analyzed by Pearson correlation or Spearman rank correlation analyses,and the consistency was analyzed by Bland-Altman analysis.Results In A group,EDV,EF and SRS measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC(EDV:(257±137)vs(276±154)ml,EF:(21±11)%vs(26±13)%,SRS:17(6,25)vs 18(8,28);t values:-2.63,-7.46,z=-2.14,all P<0.05);all parameters measured by LEHR-SPECT and IQ-SPECT had well correlation(r values:0.965,0.969,0.967,r_(s)values:0.920,0.960,all P<0.001)and consistency.In B group,EDV and EF measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC(EDV:(96±40)vs(107±39)ml,EF:(46±15)%vs(54±16)%;t values:-6.23,-10.71,both P=0.001);SRS and TPD measured by IQ-SPECT after SC and AC were significantly lower than non-SC and non-AC(SRS:2(1,4)vs 5(3,11),TPD:3%(1%,5%)vs 7%(3%,12%);z values:-4.11,-4.16,both

关 键 词：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 图像处理 计算机辅助 

分 类 号：R817.4[医药卫生—影像医学与核医学]