心肌梗死患者心肌灌注和心功能参数的定量分析

Quantitative analysis of myocardial perfusion and indexes of cardiac function in patients with myocardial infarction

目的评价AutoQUANT定量门控心肌断层显像测定心肌梗死患者左室射血分数的准确性,为康复措施的介入提供依据。方法研究对象为23例冠心病心肌梗死的男性患者。先行静息门控心肌灌注显像,1周内行平衡法核素心血池显像。将心血池显像测定的左室射血分数作为参考标准,将两种方法测得的射血分数进行相关分析。静息门控心肌显像每心动周期采集16帧图像,矩阵64×64×16,使用Vantage非线性衰减校正。采集结束后先用AutoSPECTplus进行断层重建,再用AutoQUANT进行定量心功能及灌注分析。结果①20例患者中,两种测定方法左室射血分数均大于50%7例,均小于50%者15例,1例为AutoQUANT定量门控心肌断层显像所测射血分数为65%,而平衡法心血池显像所测射血分数为45%,经相关分析,由定量门控心肌断层显像测得的射血分数和由平衡法心血池显像所测得的射血分数高度相关,相关系数为0.94。②在射血分数小于50%的15例中,有8例两种显像都可观察到室壁瘤。其中有2例平衡法心血池显像室壁瘤不如门控心肌断层显像明显。结论①心肌梗死患者的局部心肌放射性分布缺损区对AutoQUANT的定量计算准确性无明显影响。②AutoQUANT定量门控心肌断层显像显示左室舒张末期、收缩末期边界清晰,局部心肌的瘤样膨出和矛盾运动的确定客观可靠。

AIM:To evaluate the accuracy of AutoQUANT quantitative gated myocardial tomograhy on the left ventricular ejection fraction (LVEF) determination in patients with myocardial infarction (MI),so as to provide evidence for the intervention of rehabilitation measures. METHODS:Resting gated myocardial perfusion imaging was performed in 23 MI patients,then balance nuclein cardial blood pool imaging was performed within one week,and the LVEF measured with the latter one was taken as the reference standard,then the LVEFs measured with both methods were analyzed.Resting gated myocardial imaging: 16 pictures were collected per cardiac cycle,the matric was 64×64×16,and Vantage non linear attenuation correction was used. After collection,AutoSPECT plus was used for tomographic reconstuction,and then the cardiac function and perfusion analysis were performed with AutoQUANT. RESULTS:①For the 20 patients,the LVEFs over 50%were in 7 cases and less than 50%in 15 cases simultaneously measured by both methods.There was 1 case with the LVEFs of 65%and 45%measured with gated myocardial perfusion imaging and balance nuclein cardial blood pool imaging respectively.The results of correlation analysis showed that the LVEFs measured with the two methods were highly correlated(r=0.94).②Among the 15 cases with LVEFs value less than 50%,ventricular aneurysm was found in 8 patients by the two imagings,but displayed obviously in 2 patients by AutoQUANT.CONCLUSION:①Local radioactive distributed defected area of myocardium has no effect on the accuracy of LVEF determined by AutoQUANT.②End systole and end diastole territory showed clearly and local myocardial paradoxical akinesis is judged objectively by AutoQUANT.③Combined knowledge of myocardial perfusion and left ventricular function by Auto QUANT quantitative gated myocardial SPECT is useful to clinicians.