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題名 | 使用門控式心肌灌注單光子電腦斷層掃描評估小心臟受檢者左心室射出分率:比較傳統式SPECT與MyoSPECT=Assessment of Left Ventricular Ejection Fraction in Patients with Small Hearts Using Gated Myocardial Perfusion SPECT: A Comparison between Conventional SPECT and MyoSPECT |
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作 者 | 陳芓安; 林嘉嘉; 楊鶴廷; 王欣寧; 曾敬仁; | 書刊名 | Annals of Nuclear Medicine and Molecular Imaging |
卷期 | 37:1 2024.03[民113.03] |
頁次 | 頁12-20 |
分類號 | 415.2165 |
關鍵詞 | 數位化心臟專用單光子電腦斷層儀; 門控式心肌灌注造影; 左心室射出分率; Gated myocardial perfusion SPECT; Left ventricular ejection fraction; MyoSPECT; |
語文 | 中文(Chinese) |
DOI引用網址 | 10.6332/ANMMI.202403_37(1).0002 |
中文摘要 | 背景:數位化心臟專用單光子電腦斷層儀(MyoSPECT)晶體是使用碲鋅鎘固態半導體材質(cadmium zinc telluride,CZT),且多排多列的探測器排列方式使每個陣列均指向心臟,相較於傳統式SPECT使用低能量高解析準直儀單光子電腦斷層儀,能有效減少核醫心肌灌注造影的時間與提升影像解析度。臨床上,小心臟受試者以門控式心肌灌注造影執行檢查時,經常發生高估左心室射出分率(left ventricular ejection fraction,LVEF)的情形,本文探討小心臟受試者分別以傳統式SPECT與MyoSPECT執行門控式心肌灌注造影後,其LVEF結果比較。方法:此為回溯性研究,收集共247位執行門控式心肌灌注造影報告正常的受檢者,並且三個月內均執行心臟超音波檢查,其中126位使用傳統式SPECT造影,另121位使用MyoSPECT造影,兩組分別與心臟超音波的LVEF結果比較。結果:在傳統式SPECT,小心臟組和正常組平均LVEF(%)分別為65.3±4.3和59.8±5.6(p<0.01);在MyoSPECT,小心臟組和正常組平均LVEF(%)為72.8±4.3和64.6±4.8(p<0.01)。此外,將門控式心肌灌注造影與心臟超音波檢查的LVEF結果進行分析得到百分比誤差(%),在小心臟組,傳統式SPECT及MyoSPECT其百分比誤差(%)分別為9.7±7.5及6.9±5.9(p<0.05);在正常組,傳統式SPECT及MyoSPECT其百分比誤差(%)分別為13.1±8.7及11.1±7.1(p=0.14)。結論:傳統式SPECT和MyoSPECT不論在小心臟組或正常組的LVEF,皆與心臟超音波的LVEF呈現有意義相關,且無論使用傳統式SPECT或MyoSPECT執行核醫造影,均得出小心臟組高於正常組之LVEF分析結果。此外,使用MyoSPECT造影比起傳統式SPECT,LVEF分析結果更接近於心臟超音波檢查結果。 |
英文摘要 | Background: The digital cardiac-specific single-photon emission computed tomography (MyoSPECT) utilizes cadmium zinc telluride (CZT) solid-state semiconductor material, and its multi-row and multi-column detector arrangement ensures that each array is directed towards the heart. Compared to traditional SPECT using low-energy high-resolution collimators, MyoSPECT effectively reduces the time required for nuclear myocardial perfusion imaging and improves image resolution. In clinical practice, when gated myocardial perfusion imaging was performed on patients with small hearts, there is a common occurrence of overestimating the left ventricular ejection fraction (LVEF). This study aims to compare the LVEF results of patients with a small heart who underwent gated myocardial perfusion imaging by traditional SPECT and MyoSPECT, respectively. Methods: This retrospective study collected a total of 247 reports from patients who underwent gated myocardial perfusion imaging and were reported as normal. Within three months, all of them also underwent echocardiography. Out of these, 126 patients underwent traditional SPECT imaging, while 121 patients underwent MyoSPECT imaging. The LVEF results from each group were compared with the echocardiography results. Results: In traditional SPECT, the LVEF analysis results showed the patients with a small heart and normal size heart was 65.3 ± 4.3% and 59.8 ± 5.6% (p < 0.01), respectively; in MyoSPECT, the LVEF analysis results showed the patients with a small heart and normal size heart was 72.8 ± 4.3% and 64.6 ± 4.8% (p < 0.01) respectively. Besides, in small heart group, the percent deviation (%) of traditional SPECT and MyoSPECT compared to 2D-echo was 9.7 ± 7.5 and 6.9 ± 5.9 (p < 0.05) ; in normal size heart group, the percent deviation (%) of traditional SPECT and MyoSPECT compared to 2D-echo was 13.1 ± 8.7 and 11.1 ± 7.1 (p = 0.14). Conclusions: This study showed that LVEF values from GSPECT and 2D-echo were derived to have a good correlation. Regardless of whether traditional SPECT or MyoSPECT was used, LVEF calculations in patients with a small heart were more probably be overestimated. Besides, the results from MyoSPECT is closer to those obtained from 2D-echo. |
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