衰减伪影对冠心病患者门控心肌灌注显像图像质量及灌注结果的影响

Influence of Attenuation Artifacts on Image Quality and Diagnostic Results of Gated Myocardial Perfusion Imaging in Patients with Coronary Heart Disease

目的探讨衰减伪影对冠心病患者门控心肌灌注显像(GMPI)图像质量及灌注结果的影响。资料与方法回顾性分析2020年3月—2021年3月在郑州大学第一附属医院核医学科经冠状动脉造影证实且于造影前后1周行GMPI的99例冠心病患者的图像,定性及半定量分析衰减校正前后GMPI图像结果,比较衰减校正前后左心室各壁段平均放射性计数及灌注结果的差异,进一步分析衰减校正前后灌注结果不一致部分的受检者的节段性室壁运动及增厚情况。结果与衰减校正前比较,衰减校正后左心室间隔、下后壁及侧壁的平均放射性计数较高(Z=-7.302、-8.014、-3.991,P均<0.001),心尖部较低(Z=-8.021,P<0.001)。其中女性衰减校正后前壁平均放射性计数减低(Z=-2.314,P=0.021)。男性衰减校正前后下后壁放射性计数差值明显高于女性(t=-8.408,P<0.05)。衰减校正后44%(44/99)的左前降支及37%(37/99)的右冠状动脉分支供血区域显像结果发生改变,结合超声心动图及GMPI结果显示其中85%(35/41)的左前降支及81%(29/36)的右冠状动脉分支供血区域室壁运动及室壁增厚率均正常。结论衰减伪影对GMPI的图像质量和灌注结果有较大影响,结合室壁运动和增厚情况等有助于鉴别衰减伪影,提高诊断准确度与特异度。

Purpose To explore the influence of attenuation artifacts on the image quality and diagnosis results of gated myocardial perfusion imaging(GMPI)in patients with coronary heart disease.Materials and Methods Ninety-nine patients underwent GMPI and coronary angiography(CAG)in the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2021 were retrospectively enrolled,and the data of GMPI and CAG were further analyzed,the interval between GMPI and CAG was less than one week.The differences in the average radioactivity counts and imaging result of each wall section of the left ventricle between attenuation correction and no attenuation correction were compared,and the segmental wall motion and thickening of subjects with inconsistent imaging result before and after attenuation correction were further analyzed.Results Compared with no attenuation correction group,the myocardial uptake in septal wall,inferior-posterior wall,and lateral wall of the attenuation correction group were significantly increased(Z=-7.302,-8.014,-3.991,all P<0.001),while myocardial uptake in apex was remarkably decreased(Z=-8.021,P<0.001).The myocardial uptake in anterior wall of the attenuation correction group in females was slightly decreased(Z=-2.314,P=0.021).Moreover,before and after attenuation correction,the myocardial uptake of inferior-posterior wall in men was significantly higher than that in women(t=-8.408,P<0.05).In addition,compared with no attenuation correction images,the changed results of 44%(44/99)of the left anterior descending artery(LAD)and 37%(37/99)of the right coronary artery(RCA)blood supply area were detected after attenuation correction.Combined with echocardiography and GMPI results showed that 85%(35/41)of LAD and 81%(29/36)of RCA blood supply areas have normal wall motion and wall thickening rates among those subjects.Conclusion Attenuation artifacts have a great impact on image quality and diagnostic results of GMPI in patients with coronary heart disease,combining wall motion and thickening can help identify attenuation artifacts and improve GMPI diagnostic performance.