以VR RENDER軟體分析Tc-99m ECD Brain perfusion SPECT評估阻塞性呼吸中止症患者治療前後腦部血流體積

VR RENDER Software to Evaluate Tc-99m ECD Brain Perfusion SPECT Cerebral Blood Volume in Obstructive Sleep Apnea Patients before and after Treatment

陳婉甄(WAN-CHEN CHEN)

指導教授 ： 林松水

中臺科技大學/健康科學院/醫學影像暨放射科學系暨研究所/碩士(2016年)

摘要

阻塞型睡眠呼吸中止症(obstructive sleep apnea, OSA)患者常見腦部血流灌注缺損，核醫腦血流灌注掃描影像可用於評估缺損部位。秀傳亞洲微創手術中心醫學影像部研發軟體VR Render可將核醫斷層影像三維立體重組成虛擬影像，並計算腦血流體積，本研究首次使用VR-Render軟體評估OSA患者在治療前後腦血流體積的變化，結果將與Matlab分析結果作相關性驗證後，進一步將分析治療方式及疾病嚴重程度與治療後腦血流體積的恢復之差異性。
本研究共收集有21位診斷為中重度OSA患者，依治療方式分為手術治療組及正壓呼吸器治療組，受試者在治療前及後三個月各進行一次的核醫腦血流灌注掃描。掃描影像重組後以VR Render及Matlab分別計算出腦血流體積。
VR Render及Matlab所計算的腦血流體積，以皮爾森相關係數（Pearson correlation coefficient,γ）來驗證這兩種計算值結果。治療前腦血流體積計算的VR-Render與Matlab結果為低度相關γ＝0.239（p＞0.01）；治療後腦血流體積兩組計算結果為中度相關γ=0.522 （p<0.05）；治療前後腦血流體積計算結果為高度相關γ=0.700。在治療後及治療前後體積差計算值得到有顯著的相關性（p<0.01）。在治療方式及疾病嚴重程度二個因素與治療後腦部血流體積恢復無明顯相關。
以VR Render軟體計算腦血流體積經以Matlab 結果相驗證後，證實VR Render是可行的一個影像分析工具，應用在OSA患者的治療後腦血流灌注體積評估，並無需增加患者檢查時間，可在原有檢查影像外再多提供量化的數據，提供OSA患者作為更多樣的療效評估工具。

關鍵字

阻塞性睡眠呼吸中止症 ； 核醫腦血流灌注掃描 ； VR Render ； 腦部血流灌注

並列摘要

Patients with Obstructive sleep apnea (OSA) common with perfusion defect in cerebral blood flow, Tc-99m ECD brain perfusion scan can be used to assess the defect. VR Render software, developed by Medical Imaging department of Asia Institute of Telesurgery, the three-dimensional reconstruction techniques to construct virtual images ,and SPECT can be re-composition of the three-dimensional image, and calculating the cerebral blood volume. This study is the first to use VR-Render software to evaluate the changes in cerebral blood flow volume before and after treatment in patients with OSA , and to be verified the correlation with Matlab. Further we evaluate the relation between treatment type, and severity with brain perfusion volume.
A total of 21 patients with moderate to severe OSA, according to the treatment type divided into surgery and CPAP therapy group. Tc99m ECD brain perfusion scan were perform in both before and 3 months after treatment. Recon data be calculated by VR Render and Matlab into blood volume.
The blood volume calculated values of VR-Render and Matlab with weak correlation（γ＝0.239, p＞0.01）in blood volume value of pre-treatment and moderate correlation（γ=0.522 ,p<0.05） in blood volume value of post-treatment, and the blood volume value of different between pre and post treatment was highly correlated（γ=0.700, p<0.01）. Results of treatment type and severity was no statistical correlation
VR Render software calculate cerebral blood volume is a viable tool for image analysis, and indicate VR Render 3D images reorganization, without increasing patient examination time, we can calculate the volume of the brain blood flow, may provide more quantitative data outside the planar image, providing patients with OSA as a more effective tool to assess the efficacy.

並列關鍵字

obstructive sleep apnea (OSA) ； Tc-99m ECD Brain SPECT ； VR Render ； brain perfusion

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