摘要
目的:以无冠心病者为研究对象,IQ-SPECT模式采集图像,采用4DM软件对心肌节段的放射性摄取值(%)和17节段自动评分系统对结果进行评价,比较CT衰减校正(AC)对心肌灌注显像(MPI)结果判断的影响。方法:对59例行静息+负荷SPECT MPI结果为阴性,且冠状动脉造影或冠状动脉CT造影检查结果提示冠状动脉未见狭窄或狭窄<50%,对其静息心肌灌注图像进行回顾性分析。其中男性28例,女性31例,年龄(58.3±9.8)岁,体质指数(24.9±3.4)/(kg/m~2)。采用4DM软件比较衰减校正前后左心室5个大的心肌节段(心尖、前壁、间隔、下壁和侧壁)的放射性摄取值(%),以及17个心肌节段评分的变化情况。结果:AC后受检者下壁和间隔的放射性摄取值(%)显著性升高,心尖部的放射性摄取值(%)则明显降低(P<0.05)。AC后86%(51/59)的下壁和85%(50/59)间隔的放射性摄取值(%)升高,100%(59/59)心尖部放射性摄取值(%)均降低。采用17节段5分法的评分系统,AC后多数下壁(78%,46/59)、间隔(59%,35/59)和心尖部(69%,41/59)的评分保持不变。但对女性患者,AC后42%(13/31)的前壁和心尖部评分值均增加,可能会导致假阳性结果。结论:IQ-SPECT模式下,AC会导致受检者下壁和间隔的放射性摄取值(%)明显升高,心尖部则显著降低。临床医师在图像判读时需引起注意。
Objective: Using percent of radioactive counts( PRC) and auto-scores of 17 segments to evaluate the impact of CT attenuation correction( AC) on IQ-SPECT myocardial perfusion imaging( MPI) in patients without coronary artery disease. Methods: Fifty-nine patients [male 28,female 31,age( 8. 3 ± 9. 8)years,body mass index( 24. 9 ± 3. 4) kg/m~2],who had negative rest + stress MPI result,and coronary angiography or coronary CT angiography showed that the coronary artery was normal or with the stenosis < 50%,were respectively enrolled,and rest image of MPI was analyzed. Before and after AC,myocardial uptake( %)and scores were analyzed by using 4 DM software,17 segments and 5-score system. Two-sample t test was used for the comparison between patients with AC and NOAC. Independent-samples T test was used for the comparison between male and female. Results: After AC,myocardial uptake( %) in inferior wall and septal wall was remarkably increased,while myocardial uptake( %) in apex was decreased significantly( P < 0. 05). After AC,myocardial uptake( %) was increased in 86%( 51/59) inferior wall and 85%( 50/59) septal wall while it was decreased in 100%( 59/59) apex. However,scores in most inferior wall( 78%,46/59),septal wall( 59%,35/59) and apex( 69%,41/59) were not significantly changed. It indicated score was reliable.Meanwhile,after AC,in female patients,myocardial uptake was decreased in apex and anterior wall,which might lead to false positive MPI result. Conclusion: After AC,myocardial uptake was significant increased in inferior wall and septal wall,while it was significantly decreased in apex.
引文
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