QUANTITATIVE ANALYSIS OF MYOCARDIAL PERFUSION AND METABOLISM USING SPECT

1.建立了一个新的工作站，并采用一种新的配准算法对SPECT图像与其他CT或MRI解剖图像进行三维图像配准，这种配准有助于区分脑SPECT检查中的部分容积效应引起的伪影和实际低灌注。这种图像融合分析被认为是有价值的精确评价心肌灌注和功能的各种心脏疾病.心电门控心肌灌注断层显像最近已被应用于同时评价区域灌注和功能。这项新技术对于评估完全性左束分支传导阻滞患者的病理生理和疑似冠心病患者的危险分层有价值.应用碘化脂肪酸化合物（BMIPP）评价在体局部心肌代谢，在急性心肌梗死患者的随访研究中，应用SPECT灌注显像评价危险区、梗死心肌和挽救心肌。由于血运重建治疗后代谢恢复慢于灌注恢复，因此梗死后1周的BMIPP-SPECT对估计危险区域有价值。此外，BMIPP成像用于识别自发性高血压大鼠模型和肥厚型心肌病患者肥厚心肌的代谢异常。在这些心肌疾病中，代谢改变先于灌注异常。因此，SPECT灌注和代谢的联合成像可以提供对各种心肌疾病的病理生理学的了解。

1.A new workstation with a recently developed algorithm was installed to perform three-dimensional image co-registration of SPECT images with other anatomical images using CT or MRI.This image co-registration was useful to differentiate actual hypoperfusion from the artifacts due to partial volume effect on the brain SPECT studies. Such image fusion analysis is considered to be valuable for precise evaluation of myocardial perfusion and function in various cardiac diseases.2. ECG-gated myocardial perfusion SPECT has recently been applied for simultaneous evaluation of regional perfusion and function. This new technique was valuable for assessing pathophysiology in patients with complete left bundle branch block and risk stratification in patients suspected with coronary artery disease.3. Assessment of regional myocardial metabolism in vivo has been performed with use of iodinated fatty acid compound, BMIPP.In the follow-up study of patients with acute myocardial infarction, the perfusion SPECT was applied to estimate the area at risk, infarcted myocardium, and salvaged myocardium. Since metabolic recovery was slower than the perfusion recovery after revascularization therapy, BMIPP-SPECT at one week after infarction was valuable for estimating the area at risk. Furthermore, BMIPP imaging was used for identifying metabolic abnormalities in hypertrophic myocardium in the spontaneous hypertensive rat model and patients with hypertrophic cardiomyopathy. Metabolic alterations preceded perfusion abnormalities in these myocardial disorders. Thus, the combined imaging of perfusion and metabolism with SPECT may provide insight in to pathophysiology in various myocardial disorders.