Sources of variability in the radionuclide angiographic assessment of ejection fraction: a comparison of first-pass and gated equilibrium techniques.
Sources of variability in the radionuclide angiographic assessment of ejection fraction: a comparison of first-pass and gated equilibrium techniques.
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DOI：
10.1016/0002-9149(84)90412-0
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发表时间：
1984-03
期刊：
影响因子：
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通讯作者：
Sanjiv Kaul;Charles A. Boucher;Robert D. Okada;John B. Newell;H. Strauss;G. Pohost
中科院分区：
文献类型：
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作者：
Sanjiv Kaul;Charles A. Boucher;Robert D. Okada;John B. Newell;H. Strauss;G. Pohost
由首次通过和门控平衡放射性核素血管造影术测定的射血分数(EF)被广泛认为是相同的。为了在大范围的EF范围内对这些测量结果进行比较，连续135例患者在1h内进行了两种核素血管造影方法的静息左(LV)和右室(RV)EFS测量：直立和门控平衡仰卧左前斜位和门控平衡卧位。人群包括18名正常患者和117名各种心肺疾病患者。首次通过与门控平衡左心室射血分数相关性良好(r=0.001.83，p<；0.0 5)，但回归直线斜率不同于1，首次通过值低于门控平衡值(0.5 1±0.16比0.5 6±0.15，p<；0.0 5[均数±标准差])。门控平衡左心室射血分数为0.50的45例患者的相关性(r=0.84)好于门控平衡左心室射血分数为0.50的90例(r=0.44，p<；0.05)。然而，在后一组中，15例因主动脉或二尖瓣返流而导致的心脏增大的相关性仍然良好(r=0.80)。两种方法的观察者间和观察者内误差相似。相反，首过和门控平衡RVEF的相关性较差，首过值高于门控平衡值(0.51±0.11比0.43±0.11，p<；0.01)。两种方法的观察者间误差相似，但首次通过法的观察者内误差更好(p<；0.05)。因此，由于测量方法的不同，同一患者静息时的放射性核素EF可能会有相当大的变异性。在比较使用不同放射性核素方法得出的EF值时，建议谨慎行事。
Measurements of ejection fractions (EF) determined by first-pass and gated equilibrium radionuclide angiography are widely believed to be equivalent. To compare these measurements in a large group of patients over a wide range of EF values, left ventricular (LV) and right ventricular (RV) EFs at rest were measured in 135 consecutive patients who underwent the 2 methods of radionuclide angiography within 1 hour: first-pass upright with a multi-crystal camera in the anterior projection and gated equilibrium supine with a single-crystal camera in the left anterior oblique projection. The population included 18 normal patients and 117 patients with various cardiac and pulmonary disorders. First-pass and gated equilibrium LVEF correlated well (r = 0.83, p <0.001), but the slope of the regression line was different from unity, with the first-pass values lower than the gated equilibrium values (0.51 ± 0.16 vs 0.56 ± 0.15, p <0.05 [mean ± standard deviation]). Among the 45 patients with a gated equilibrium LVEF of <0.50, the correlation (r = 0.84) was better than that for the 90 patients with a LVEF > 0.50 (r = 0.44, p <0.05). However, in the latter group, the correlation remained good in the 15 patients with cardiomegaly due to aortic or mitral regurgitation (r = 0.80). Inter- and intraobserver error was similar for both methods. In contrast, there was a poor correlation between first-pass and gated equilibrium RVEF, with the first-pass values higher than the gated equilibrium values (0.51 ± 0.11 vs 0.43 ± 0.11, p <0.01). Interobserver error was similar for both the methods, but intraobserver error was better for the first-pass method (p <0.05). Thus, there may be considerable variability in the radionuclide EF at rest in the same patient because of differences in the method of measurement. Caution is suggested when EF values that have been derived using different radionuclide methods are compared.