碲锌镉SPECT平衡法门控心血池断层显像重建平面及快速显像方案的研究

Study of tomographic gated equilibrium radionuclide angiography on reconstructed-planar imaging and rapid acquisition mode with cadmium zinc telluride SPECT

目的 通过对比分析传统NaI-SPECT平衡法门控心血池平面显像(简称NaI-SPECT平面显像)与心脏专用碲锌镉(CZT)SPECT(CZT-SPECT)平衡法门控心血池断层显像(简称CZT-SPECT断层显像)及其重建平面显像(简称CZT-SPECT断层重建平面显像)所获得的左、右心室功能参数的相关性及其差异,进行CZT-SPECT断层显像的方法学研究并探讨其优势.方法 回顾性分析2021年8月至2022年11月在泰达国际心血管病医院行放射性核素平衡法门控心血池显像的患者58例[其中,男性38例、女性20例,年龄(60.6±12.3)岁],所有患者均于同日先后行NaI-SPECT平面显像和CZT-SPECT断层显像,重建CZT-SPECT断层显像数据成平面显像数据,比较和分析NaI-SPECT平面显像(P)、CZT-SPECT断层显像(T)及其重建平面显像(re)获得的左心室射血分数(LVEF)和右心室射血分数(RVEF).重建3、4和5 min的CZT-SPECT断层显像采集数据,将获得的 LVEF(3 min)、LVEF(4min)、LVEF(5 min)和 RVEF(3 min)、RVEF(4min)、RVEF(5 min)与原始采集数据 LVEF(10 min)、RVEF(10 min)进行比较.将LVEF(10min)和RVEF(10min)按≥20%、≥30%、≥40%和≥50%重新分为各亚组,并与上述重建数据分别进行分析.计量资料的比较采用配对t检验(或Wilcoxon符号秩检验),相关性采用Pearson(或 Spearman)相关性分析.结果 LVEF(re)[30.50%(20.00%,38.50%)]、LVEF(P)[31.00%(22.00%,41.00%)]与 LVEF(T)[27.00%(19.75%,38.50%)]之间的差异均有统计学意义(Z=-2.645、-3.065,均P<0.05),LVEF(re)与 LVEF(P)之间的差异无统计学意义(Z=-1.057,P>0.05);RVEF(P)(39.78%±12.16%)、RVEF(T)(41.57%±15.18%)和 RVEF(re)(40.88%±13.19%)之间两两比较,差异均无统计学意义(t=-1.949、-1.721、0.883,均P>0.05);3种显像方法获得的LVEF、RVEF比较,两两之间的相关性均为优秀(r=0.892~0.946,均P<0.001);LVEF(3min)、LVEF(4min)、LVEF(5 min)和 RVEF(3 min)、RVEF(4min)、RVEF(5 min)分别与 LVEF(10 min)和 RVEF(10min)比较,差异均有统计学意义(Z=-2.798、-3.288、-3.995,t=-2.187、-3.976、-5.154,均P<0.05),且相关性均为优秀(r=0.903~0.970,均P<0.001).亚组分析结果显示,除LVEF≥20%亚组外,其余各亚组中,LVEF(5min)与 LVEF(10min)、RVEF(5 min)与 RVEF(10 min)之间的差异均无统计学意义(Z=-1.853~-1.158,t=-1.804、-0.132,均 P>0.05).结论 CZT-SPECT断层显像可通过重建获得平面显像数据,结合采集性能优势,可在获得可靠的数据用于后期处理和获得准确的测量结果的同时,进一步降低检查中的辐射剂量或缩短时间.

Objective To analyze the correlation and difference of biventricular function from planar gated equilibrium radionuclide angiography with conventional sodium iodide SPECT(NaI-SPECT planar imaging)and tomographic gated equilibrium radionuclide angiography with cadmium zinc telluride SPECT(CZT-SPECT tomographic imaging),and reconstructed-planar imaging from CZT-SPECT tomographic imaging(CZT-SPECT re-planar imaging)to investigate the methodology and advantages of CZT-SPECT tomographic imaging.Methods A retrospective analysis was performed on 58 patients(38 males and 20 females aged(60.6±12.3)years),who underwent gated equilibrium radionuclide angiography in TEDA International Cardiovascular Hospital from August 2021 to November 2022.All patients were subjected to NaI-SPECT planar imaging and CZT-SPECT tomographic imaging on the same day.CZT-SPECT tomographic imaging data were reprocessed in re-planar form and at different acquisition times.The left ventricular ejection fraction(LVEF)and right ventricular ejection fraction(RVEF)of NaI-SPECT planar imaging(P),CZT-SPECT tomographic imaging(T),and CZT-SPECT re-planar imaging(re)were compared and analyzed,and the CZT-SPECT tomographic imaging acquisition data at 3,4,and 5 min were reconstructed.The LVEF(3 min),LVEF(4 min),LVEF(5 min),and RVEF(3 min),RVEF(4 min),RVEF(5 min)were compared with the original acquisition data LVEF(10 min)and RVEF(10 min),respectively.Divide LVEF(10 min)and RVEF(10 min)into subgroups of≥20%,≥30%,≥40%,and≥50%,and analyze them separately with the reconstructed data mentioned above.Paired t-test(or Wilcoxon signed rank test)and Pearson(or Spearman)were used in analyzing differences and correlations among the data.Results The differences among LVEF(re)(30.50%(20.00%,38.50%)),LVEF(P)(31.00%(22.00%,41.00%)),and LVEF(T)(27.00%(19.75%,38.50%))were statistically significant(Z=−2.645,−3.065;both P<0.05),whereas the differences between LVEF(re)and LVEF(P)were not statistically significant(Z=−1.057;P>0.05).No significant difference was found among RVEF(P)(39.78%±12.16%),RVEF(T)(41.57%±15.18%)and RVEF(re)(40.88%±13.19%;t=−1.949,−1.721,0.883;all P>0.05).The LVEF and RVEF correlations obtained by the three imaging methods were excellent(r=0.892–0.946;all P<0.001).The differences between LVEF(3 min),LVEF(4 min),LVEF(5 min),and LVEF(10 min),and between RVEF(3 min),RVEF(4 min),RVEF(5 min),and RVEF(10 min)were statistically significant(Z=−2.798,−3.288,and−3.995;t=−2.187,−3.976,and−5.154;all P<0.05),and the correlations were excellent(r=0.903–0.970;all P<0.001).Subgroup analysis showed no significant difference between LVEF(5 min)and LVEF(10 min)and between RVEF(5 min)and RVEF(10 min)in all subgroups,except the LVEF≥20%subgroup(Z=−1.853 to−1.158;t=−1.804,−0.132;all P>0.05).Conclusions CZT-SPECT tomographic imaging can obtain planar datasets through reconstruction.Owing to its acquisition performance,CZT-SPECT tomographic imaging can further reduce the radiation dose or time for examination while obtaining reliable data for postprocessing and accurate measurement results.