SPECT-MPI与256排CTA 3D图像异机融合的实验研究

Preliminary Experimental Validation of a New Image Fusion Software for Three Dimensional Integration of SPECT-MPI and Stand-alone 256-slice CTA

目的:本研究旨在探讨并验证患者MPI与CTA 3D图像异机融合的可行性。方法:对30名可疑冠心病患者分别进行SPECT-MPI、256排CTA,经上述无创性检查后行ICA。利用MIPAV软件对MPI、CTA图像进行以特征为基础的3D异机融合。以DSA结果为金标准,评价CTA图像和异机融合图像结果,并判断是否因异机融合更为明确责任血管和血流灌注缺损区的关系,以及是否提供额外的诊断信息。结果:利用MIPAV软件可将SPECT-MPI和256排CTA所采集图像较为理想地进行异机融合。异机融合图像形象直观,并可明确狭窄冠脉和血流灌注缺损区的关系,诊断准确性提高。额外的诊断信息多见于存在多支冠脉病变或多处心肌血流灌注缺损的患者(P=0.003)。结论:对于患者SPECT-MPI和心脏冠脉CTA图像,利用MIPAV软件进行3D图像异机融合具有临床可行性,部分患者可提供额外的诊断信息,并有助于冠心病的诊断及临床治疗。

Purpose：The aim of the present study was an exploration and a validation of software-based image fusion between SPECT-MPI and stand-alone CTA on patients.Methods：Thirty consecutive patients with clinical doubted coronary artery disease on SPECT-MPI,CTA,and DSA were included.Featurebased integration of SPECT images with CTA images was performed on a remote workstation using MIPAV software.Results：MIPAV software could be used to integrate successfully of SPECT images with stand-alone CTA images.These fusion images provide a panoramic view of the myocardium,the regional myocardial perfusion and the coronary artery tree,eliminating the uncertainties in the relationship of perfusion defects and culprit coronary arteries.Extra useful diagnosis information was usually existed in the patients with multiple perfusion abnormalities or multiple stenosis coronary artery diseases （P=0.003）.Conclusion：3D integration of SPECT-MPI with stand-alone CTA images is clinical feasible using MIPAV software.It can provide some more diagnosis information particular for multi-vessel stenosed or multiple perfusion abnormalities in patients,and it will be helpful for diagnosing and further guiding the clinical practice on CAD patients.