心脏三维重塑技术对改善心肌灌注显像质量的应用

Evaluation of cardiac morphing to improve the quality of myocardial perfusion imaging

目的探讨心脏三维重塑技术对减少心脏生理性运动伪影、提高心肌血流灌注显像的作用。方法回顾性分析2011年3月至2011年8月首次就诊者20名。其中8名根据年龄、临床症状、ECG、CTCA等资料排除其患冠心病可能性，12名在2周内接受CAG检查，结果均为阴性。行99Tcm-MIBI常规MPI，通过心脏三维重塑专用软件对心肌断层图像进行三维重塑处理。由2位有经验的核医学科医师在双盲情况下，通过目测结合极坐标靶心图行定量分析，获得心肌核素稀疏或缺损的节段数以及心肌各壁的放射性计数百分比，采用配对t检验比较三维重塑前后图像差异。结果所有受检者中，心脏非三维重塑模式可见10个放射性稀疏节段，而三维重塑模式仅见4个稀疏节段。采用三维重塑模式可减少心尖和前壁放射性稀疏伪影。非三维重塑模式心尖和前壁放射性计数百分比分别为（78．05±0．83）％、（74．50±2．35）％，三维重塑后分别为（84．05±1．32）％、（81．10±1．45）％，2种处理模式比较差异有统计学意义（t心尖=11．854，t前壁=9．413，P均〈0．05）。前侧壁、后侧壁、前间隔、后间隔、下壁和后壁非三维重塑模式与三维重塑模式放射性计数比较差异无统计学意义（t值分别为1．876、1．330、1．690、2．014、0．167和1．868，P均〉0．05）。结论心脏三维重塑技术可以有效减少心脏生理性运动引起的心脏伪影，其图像质量明显优于非三维重塑模式。

Objective To explore the value of cardiac morphing in reducing cardiac motion arti- facts and improving the quality of MPI. Methods In this retrospective study, 20 healthy volunteers under- went MPI with cardiac morphing at initial consultation during March 2011 to August 2011. Coronary artery disease （CAD） was excluded in 8 patients according to their age, clinical features, ECG and CTCA. CAD was excluded by CAG in 12 patients. The number of sparse segments and the percentage of average count at the myocardial wall were obtained by 99Tcm-MIBI MPI. Cardiac morphing was performed with the workstation of GE Discovery D670 SPECT. Two experienced nuclear medicine physicians, who were blinded to each other, measured the percentage of average count in the polar bulls-eye map. The difference was compared by paired t-test. Results A total of 10 sparse segments were identified without a morphing mode, while 4 sparse segments were identified using a morphing mode. The artifacts were reduced in apex and an- terior walls using the morphing mode. The percentages of average count in the apex and anterior walls were （ 78.05 ± 0.83 ） % and （74.50 ±2.35 ） %, respectively, without a morphing mode and （ 84.05 ± 1.32） % and （81.10 ± 1.45 ）% , respectively, with a morphing mode. Their differences were statistically significant （apex： t = 11. 854; anterior wall： t = 9.413, both P 〈0.05）. There was no significant difference between these modes in the anterolateral, posterolateral, anterior and posterior walls, as well as inferior and posterior septa （t = 1. 876, 1. 330, 1. 690, 2.014, 0. 167, 1. 868, all P 〉 0.05 ）. Conclusion Cardiac morphing can effectively reduce cardiac motion artifacts and improve the image quality of MPI.