滤波反投影法和OSEM重建图像测量心功能参数的比较

Comparison of cardiac function parameters in gated myocardial SPECT determined by filtered backprojection and OSEM reconstruction methods

目的比较静息门控心肌显像滤波反投影法（FBP）和OSEM重建图像后用定量门控心肌断层显像（QGS）、四维模型心肌断层显像（4D—MSPECT）、爱莫瑞心脏工具箱（ECToolbox）软件测量的心功能参数。方法临床疑诊或确诊冠心病患者144例，均行^99Tc^m-MIBI静息门控心肌SPECT显像，所有患者均用FBP和OSEM重建图像，用QGS、4D—MSPECT、ECToolbox软件计算心功能参数LVEF，EDV和ESV，采用Bland—Altman法检验2种重建方法的一致性，配对t检验方法检验心功能参数差异，相关性分析用直线回归分析。结果FBP和OSEM重建测量的心功能参数一致性和相关性好（r均〉0．93，P均〈0．001）。QGS软件FBP重建测得的EDV低于OSEM重建测得的EDV，其他2种软件为FBP高于OSEM[QGS：（82．2±39．1）ml和（83．5±40．8）ml，t=-2．53，P〈0．05；4D—MSPECT：（93．5±46．9）ml和（88．8±45．2）ml，t=5．95，P〈0．01；ECToolbox：（106．4±51．1）ml和（100．8±49．0）ml，t=3．99，P〈0．01]。对于ESV，4D-MSPECT软件FBP测量值高于OSEM[（37．5±41．4）ml和（34．8±37．6）ml，t=3．92，P〈0．01]。QGS软件FBP测得的LVEF低于OSEM测得的LVEF[（62．1±16．9）％和（63．1±16．1）％，t=-3．14，P〈0．01]。ECToolbox软件FBP测得的LVEF高于用OSEM测得的LVEF[（74．1±18．8）％和（71．3±17．1）％，t=5．28，P〈0．01]。结论2种重建方法所测量的心功能参数虽然相关性和一致性很好，但某些参数值差异有统计学意义。

Objective To compare the cardiac function parameters in gated SPECT determined by filtered back projection （FBP） and OSEM reconstruction methods. Methods One hundred and forty-four patients underwent ^99Tc^m-MIBI gated-SPECT imaging studies. The parameters LVEF, EDV and ESV, were derived using quantitative gated SPECT （QGS）, four-dimensional model SPECT （4D-MSPECT） and emory cardiac toolbox （ECToolbox） softwares. Each image was reconstructed by FBP or OSEM. Bland-Altman analysis and paired t-test were applied to evaluate those parameters. Results Correlation coefficients for LVEF, EDV and ESV between FBP and OSEM methods were all more than 0. 93 （ all P 〈 0. 001 ）. EDV calculated by FBP was lower than that by OSEM using QGS software, but became the opposite when using 4D-MSPECT and ECToolbox softwares. （ QGS ： （82.2 ± 39.1 ） ml vs （83.5 ± 40.8） ml, t = - 2.53, P 〈 0. 05 ; 4D-MSPECT ： （93.5 ± 46.9） ml vs （88.8 ± 45.2） ml, t = 5.95, P 〈 0. 01 ; ECToolbox ： （ 106.4 ± 51.1 ） ml vs （ 100.8 ± 49.0） ml, t = 3.99, P 〈 0.01 ）. ESV calculated by FBP was higher than that by OSEM using 4D-MSPECT software （4D-MSPECT： （37.5 ＋41.4） ml vs （34.8 ± 37.6） ml, t = 3.92, P 〈 0. 01 ）. LVEF calculated by FBP was lower than that by OSEM using QGS software （ （62.1 ± 16.9 ） % vs （63.1 ±16. 1）%, t = -3. 14, P 〈0.05）, but higher than that by OSEM using ECToolbox software （（74.1±18.8）% vs （71.3±17.1）%, t=5.28, P〈0.01）. Conclusion Generally, cardiac functional parameters based on FBP and OSEM construction methods correlated well, although they might have singnifieanfly different results.