门控心肌灌注显像与超声心动图评价左室功能和容积

Comparison Between Gated Myocardial Perfusing Imaging and Echocardiography for Assessment of Left Ventricula Function and Volumes

目的评价门控心肌灌注显像(SPECT)与超声心动图在测定左室功能和容积方面的相关性。方法65例不同诊断的患者在15d内分别接受99TcmMIBI门控SPECT和超声心动图检查,对两种方法测得的左室射血分数(LVEF)、舒张末容积(EDV)和收缩末容积(ESV)的值进行比较,并进行相关性分析。将所有病人分为Ⅰ组(EDV<90mL,n=31)和Ⅱ组(EDV>90mL,n=34),比较两组之间两种方法测量结果间的关系。结果门控SPECT测得的LVEF、EDV和ESV与超声结果间具有良好的相关性,两者间无统计学差异。在Ⅰ组中,与超声心动图结果相比,门控SPECT测定的LVEF要高(P<0.05),而测量的ESV要低(P<0.05),测量的EDV间无明显差异。在Ⅱ组中,两种方法测量的各结果间无明显差异。结论门控SPECT与超声心动图在测定LVEF和左室容积方面具有良好的相关性,但是对于心室腔较小的病人,门控SPECT可能会由于低估左室收缩末期容积而对LVEF产生高估。

Objective To evaluate left ventricular volumes and function by gated myocardial perfusing imaging SPECT in comparison with echocardiography. Methods Consecutive 65 patients who underwent both gated SPECT and echocardiography within a 15 d period were selected for the study. The data, including left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were obtained using AUTOQUANT software, whereas echocardiography used standard techniques. In order to compare the results of gated SPECT with echocardiography on different left volumes, all patients were divided into two groups: EDV<90 mL (n=31) and EDV>90 mL (n=34), based on EDV measurements by echocardiography. Results There were good correlations between the two techniques with respect to determinations of LVEF, EDV, ESV. The LVE, EDV and ESV by gated SPECT were similar to echocardiography. The patients with smaller left ventricular volumes (EDV<90 mL) had higher LVEF(P<0.05) by gated SPECT than echocardiography, and smaller with regard to ESV (P<0.05), and similar with EDV. The patients with larger left ventricular volumes (EDV>90 mL) had similar LVEF, EDV and ESV by gated SPECT rather than echocardiography. Conclusion Quantitative gated myocardial perfusion SPECT had a good correlation with echocardiography for the measurements of LVEF and absolute LV volumes. However, gated SPECT may overestimate LVEF but underestimate LV ESV in patients with smaller left ventricular volumes.