SPECT门控心肌灌注显像定量分析的诊断价值

Diagnostic Value of Quantification of Gated Myocardial Perfusion Imaging

目的:探讨SPECT门控心肌灌注显像定量分析在提高诊断准确性方面的应用价值。方法:回顾分析112例具有完整的^(99m)Tc-MIBI门控静息/负荷心肌灌注显像资料和冠状动脉造影结果的患者资料。由3名有经验的核医学医师首先对SPECT心肌灌注显像的断层图像进行了分析并做出诊断,然后应用定量分析软件对门控图像进行定量分析获得左心室射血分数(LVEF)等功能指标并动态显示室壁运动情况,结合断层图像再次进行图像分析。以冠状动脉动脉造影的结果为标准,对比分析是否应用定量分析软件时诊断的敏感性、特异性和准确性。分析除LVEF外的其他功能性指标对诊断是否具有帮助。结果:112例患者冠状造影结果显示共计有147支冠状动脉管腔狭窄>50%。单纯SPECT心肌灌注显像断层图像目测分析诊断的敏感性、特异性和准确性分别为91.8%、86.8%和90.0%。综合分析断层图像与定量分析指标,诊断的敏感性、特异性和准确性分别为95. 9%、94.2%和94.9%。除LVEF外,其他定量分析指标被认为对诊断具有帮助的占59.8%(67/112),认为不确定者23.2%(26/ 112),认为没有价值者占17.0%(19/112)。结论:借助于定量分析软件可以明显的提高SPECT心肌灌注显像诊断的准确性。

Objective： To evaluate the diagnostic value of gated SPECT myocardial perfusion imaging using quantitative soft ware. Methods：Gated myocardial perfusion and coronary artery angiograms of 112 patients were reviewed. Firstly the tomo-graphics of myocardial perfusion imaging were analyzed by three experienced nuclear medicine physician. And then the tomo- graphics were analyzed again combined with the left ventricular functional information and observing the wall motion of left ven tricular provided by quantitative software. Compare the diagnostic sensitivity, specificity and accuracy with or without quantitative software. Results： There were 147 coronary artery branches cavity stenoses more than 50% in 112 patients. The diagnostic sensitivity, specificity and accuracy with only slices of SPECT myocardial perfusion imaging was 91.8%,86.8% and 90.0%. The diagnostic sensitivity, specificity and accuracy combined slice of SPECT myocardial perfusion imaging with functional information from quantitative software was 95.9%, 94.2% and 94. 9%. Except for the LVEF, others functional information such as end diastole volume and systole volume were considerate helpful in improving diagnostic accuracy in 59.8 % cases. Conclusion; Myocardial perfusion quantitative software was helpful in improving the diagnostic accuracy.