定量门控^(201)Tl心肌灌注显像测量左心室功能的临床研究

Clinical study of quantitative gated myocardial perfusion single photon emission computed tomography with ^(201)Tl on evaluation of left ventricular function.

目的:探讨定量门控201Tl心肌灌注显像测量左心室功能的临床价值。方法:选择32例不同左心室功能受试者于3日内完成201Tl心肌灌注显像和门控心血池显像测量,比较两者测量的左心室功能参数的相关性;选择128例患冠心病风险概率极低者(小于10%)行201Tl心肌灌注显像检测,建立201Tl心肌灌注显像测量静息左心室射血分数的正常参考值;选择113例不同左心室功能受试者于7日内完成201Tl心肌灌注显像和二维超声心动描记术检测,评价两者测量左心室局部室壁运动的符合程度。结果:201Tl心肌灌注显像和门控心血池显像测量32例不同左心室功能受试者的3项静息左心室功能参数结果分别为:左心室射血分数犤(0.58±0.02)、(0.60±0.02)犦、舒张末期容积犤(67±5)mL、(79±6)mL犦、收缩末期容积犤(30±5)mL、(33±4)mL犦,两者比较的相关系数r分别为0.89、0.87、0.96,均呈显著的正相关(均为P<0.01)。左心室射血分数的正常参考值等于或超过0.43。201Tl心肌灌注显像评价室壁运动与二维超声心动描记术的结果中等符合(Kappa值=0.52,P<0.01)。结论:201Tl心肌灌注显像能准确地评价左心室功能,有较高的临床实用价值。

Objective:To evaluate the clinical value of quantitative gated myocardial perfusion single photon emission computed tomography (SPECT) with 201Thallium (201Tl QGSPECT) on measuring left ventricular (LV) function. Methods:201Tl QGSPECT and gated blood pool imaging were performed within 72 hours in 32 patients with different LV function.The correlation of LV functional paramaters measured by 201Tl QGSPECT and gated blood pool imaging was analyzed. 201Tl QGSPECT was performed on 128 cases with a low Bayesian likelihood (<10%) of coronary artery disease. The normal reference for resting left ventricular ejection fraction (LVEF) values was evaluated. Agreement of left ventricular regional wall motions was evaluated by 201Tl QGSPECT and two dimensional echocardiography in 113 cases with different LV function. Results:The correlation between rest 201Tl QGSPECT and rest gated blood pool imaging was:r=0.89 for LVEF (P<0.01),0.87 for end diastolic volume (EDV) (P<0.01) and 0.96 for end systolic volume (ESV) (P<0.01).The normal reference for resting LVEF was ≥0.43 in 201Tl QGSPECT. There was moderate agreement between 201Tl QGSPECT and echocardiography for regional wall motion (Kappa=0.52,P<0.01). Conclusion:Quantification of LV function can be accurately evaluated by using 201Tl QGSPECT.