201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography.
201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography.
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201Tl 和 99mTc-MIBI 门控 SPECT 在大灌注缺陷和左心室功能障碍患者中的应用：与平衡放射性核素血管造影的比较。
DOI：
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发表时间：
1999
影响因子：
9.3
通讯作者：
Le Guludec
中科院分区：
文献类型：
--
作者：
Alain Manrique;Marc Paraggi;VÃ Pierre;Didier Vilain;R. Lebtahi;Alain Cribier;Dominique;Le Guludec
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左心室射血分数（LVEF）是冠心病的一个主要预后因素，可通过99 mTc-甲氧基异丁基异腈（MIBI）门控SPECT计算。然而，201 Tl仍然广泛用于评估心肌灌注和存活率。因此，我们评价了99 mTc-MIBI和201 Tl门控SPECT在心肌梗死、大面积灌注缺损和左心室（LV）功能不全患者中评估LVEF的可行性和准确性。
方法
研究了50例有心肌梗死病史的连续患者（43例男性，7例女性;平均年龄61 ± 17岁）（前壁，26例;下壁，18例;侧壁，6例）。所有患者均于注射99 mTc-MIBI 1110 MBq后1 h（组1）或注射201 Tl 185-203 MBq后4 h（组2）用90 °双探头照相机行平衡法核素心肌显像（ERNA）和静息心肌门控SPECT。经滤波反投影（巴特沃思滤波器：5阶，截止值0.25 99 mTc或0.20 201 Tl）后，使用先前验证的半自动市售软件定量门控SPECT（QGS）从重建门控SPECT计算LVEF。灌注缺损以复合非增强SPECT的靶心极图测量的整个心肌平面的百分比表示。
结果
门控SPECT图像质量被认为适用于所有患者的LVEF测量。平均灌注缺陷为36% ± 18%（第1组）、33% ± 17%（第2组）、34% ± 17%（第1组+第2组）。与ERNA相比，门控SPECT低估了LVEF（分别为34% ± 12%和39% ± 12%; P = 0.0001）。相关性较高（第1组，r= 0.88;第2组，r = 0.76;第1组+第2组，r = 0.82），Bland-Altman图显示门控SPECT和ERNA之间的一致性较好。两种方法之间的差异不随LVEF、灌注缺损大小或深度增加或缺损累及二尖瓣平面而变化。
结论
在大面积灌注缺损和左室功能不全的患者中，使用心肌门控SPECT和QGS方法测量LVEF是可行的。然而，201 Tl和99 mTc-MIBI门控SPECT同样显著低估了左室功能不全和大灌注缺损患者的LVEF。
UNLABELLED
Left ventricular ejection fraction (LVEF) is a major prognostic factor in coronary artery disease and may be computed by 99mTc-methoxyisobutyl isonitrile (MIBI) gated SPECT. However, 201Tl remains widely used for assessing myocardial perfusion and viability. Therefore, we evaluated the feasibility and accuracy of both 99mTc-MIBI and 201Tl gated SPECT in assessing LVEF in patients with myocardial infarction, large perfusion defects and left ventricular (LV) dysfunction.
METHODS
Fifty consecutive patients (43 men, 7 women; mean age 61 +/- 17 y) with a history of myocardial infarction (anterior, 26; inferior, 18; lateral, 6) were studied. All patients underwent equilibnum radionuclide angiography (ERNA) and rest myocardial gated SPECT, either 1 h after the injection of 1110 MBq 99mTc-MIBI (n = 19, group 1) or 4 h after the injection of 185-203 MBq 201Tl (n = 31, group 2) using a 90 degrees dual-head camera. After filtered backprojection (Butterworth filter: order 5, cutoff 0.25 99mTc or 0.20 201Tl), LVEF was calculated from reconstructed gated SPECT with a previously validated semiautomatic commercially available software quantitative gated SPECT (QGS). Perfusion defects were expressed as a percentage of the whole myocardium planimetered by bull's-eye polar map of composite nongated SPECT.
RESULTS
Gated SPECT image quality was considered suitable for LVEF measurement in all patients. Mean perfusion defects were 36% +/- 18% (group 1), 33% +/- 17% (group 2), 34% +/- 17% (group 1 + group 2). LVEF was underestimated using gated SPECT compared with ERNA (34% +/- 12% and 39% +/- 12%, respectively; P = 0.0001). Correlations were high (group 1, r= 0.88; group 2, r = 0.76; group 1 + group 2, r = 0.82), and Bland-Altman plots showed a fair agreement between gated SPECT and ERNA. The difference between the two methods did not vary as LVEF, perfusion defect size or seventy increased or when the mitral valve plane was involved in the defect.
CONCLUSION
LVEF measurement is feasible using myocardial gated SPECT with the QGS method in patients with large perfusion defects and LV dysfunction. However, both 201Tl and 99mTc-MIBI gated SPECT similarly and significantly underestimated LVEF in patients with LV dysfunction and large perfusion defects.
DOI：
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发表时间：
1995-11
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
通讯作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
超声心动图连续评估左心室收缩和舒张功能：图像采集、定量和生理变异在临床和研究应用中的重要性。
DOI：
10.1016/s0894-7317(14)80020-5
发表时间：
1991
期刊：
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
影响因子：
--
作者：
Kuecherer,HF;Kee,LL;Modin,G;Cheitlin,MD;Schiller,NB
通讯作者：
Schiller,NB