ECToolbox软件测量^(99)Tc^m-MIBI门控心肌显像左室射血分数临床研究

Clinical study of left ventricular ejection fraction measured from gated myocardial perfusion SPECT with ^(99)Tc^m-MIBI by ECToolbox software

目的评价ECToolbox软件测量门控心肌显像左室射血分数(LVEF)的临床价值。方法使用ECToolbox软件,将58例99Tcm-MIBI门控心肌显像患者按左室舒张末容积(EDV)分为<70 ml、70～100 ml及≥100 ml三组,分别测量并记录其R0、R1及R2的LVEF,并于1周内行门控心血池显像,比较两种显像LVEF测量值的相关性和一致性。结果 EDV<70 ml时门控心肌显像与心血池测量值没有相关性,3种测量值均被显著高估,R1值相对最接近门控心血池测量值。EDV在70～100 ml时,门控心肌显像与心血池显像测量值具有相关性,R1值与心血池显像测量值无显著差异。EDV≥100 ml时,门控心肌显像与心血池显像测量值具有极强的相关性,R0值与心血池显像测量值无显著差异。R0在EDV<70 ml和EDV≥100 ml时以及R1在各组中对心脏收缩功能是否正常的判断与心血池显像的一致性较好。结论门控心肌显像ECToolbox软件LVEF测量值与心血池显像的相关性与一致性均与EDV大小有关,EDV<100 ml时应使用R1值,但当EDV<70 ml时误差可能较大,EDV≥100 ml时应该使用R0值。

Objective To evaluate clinical value of ECToolbox software measuring left ventricular ejection fraction（LVEF） by gated myocardial imaging.Methods Rest gated myocardial SPECTS with 99Tcm-MIBI was performed on fifty-eight patients by ECToolbox software.All patients were divided into three groups according to EDV.R0,R1 and R2 were recorded.Equilibrium gated blood-pool imaging was also performed within a week.The correlation and concordance of the two methods measuring LVEF were observed.Results When EDV70 ml,there were no correlations between the two methods.The LVEF measured by ECToolbox software was significantly higher than that of gated blood-pool imaging.R1 was better.When EDV was between 70 and 100 ml,there was positive correlation between two methods and there was no significant difference of LVEF measured by R1 and gated blood-pool imaging.When EDV≥100 ml,there was strong correlation between the two methods and there was no significant difference of LVEF measured by R0 and gated blood-pool imaging.Conclusions The correlations and concordances of ECToolbox software and gated blood-pool imaging when measuring LVEF were all affected by EDV.R1 should be used when EDV was smaller than 100 ml,otherwise R0 should be used.