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Performance of Thallium-201 Electrocardiography-Gated Myocardial Perfusion Single Photon Emission Computed Tomography to Assess Left Ventricular Function

鉈-201心電圖同步心肌灌注電腦斷層掃描在評估左心室功能的效用

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摘要


本研究的目的在評估鉈-201(201T1)心電圖同步心肌灌注電腦斷層掃描(gated SPECT)在台灣人測量左心室射出分率(LVEF),舒張終期體積(EDV)和收縮終期體積(ESV)上的效用。我們的分析包含了201T1-gated SPECT在作這些測量的可重複性、再現性以及與心臟超音波的相關性。所有的病人均接受了備鎮心壓力/再分佈201T1-gated SPECT檢查,其中有18位病人在30分鐘之內進行了兩次休息狀態掃描用以評估可重複性。另28位病人則在201T1-gated SPECT檢查的7天之內也接受了心臟超音波檢查以進行比較。在可重複性的研究上,我們發現連續兩次201T1-gated SPECT在測量LVEF,EDV和ESV均呈現極優異的相關性,兩次測量絕對值的2個標準差分別為6.4%,16.8 mL和8.6 mL。而201T1-gated SPECT的再分佈影像測量LVEF,EDV和ESV的結果,與心臟超音波也呈現高度的相關性,其中LVEF的數位在兩者是相近的,但在EDV和ESV方面,心臟超音波則明顯較高。我們的研究顯示201T1-gated SPECT用在台灣人身上測量LVEF,EDV和ESV具有高度的可複性,並且與心臟超音波的結果有優異的相關性,我們認為在常規的201T1心肌灌注掃描加入gated SPECT的技術是可行的。

並列摘要


This study evaluated the performance of gated single photon emission computed tomography (SPECT) with thallium-201 (201T1) in assessing left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) in Taiwanese by determining repeatability and correlation with two-dimensional (2D) echocardiography. A total of 18 patients underwent two sequential gated SPECT acquisitions within 30 minutes in the resting state to assess repeatability. Another 28 patients who underwent gated SPIECT and 2D echocardiography within 7 days were included for comparison. The two sequential measurements were well correlated with respect to LVEF, EDV, and ESV (r=0.97, 0.95, and 0.97, respectively, all p<0.0001). Bland-Altman analysis revealed that two standard deviations of the absolute difference between the two sequential measurements for LVEF, EDV, and ESV were 6.4%, 16.8 mL, and 8.6 mL, respectively. For LVEF, EDV, and ESV, correlations between redistribution 201T1-gated SPECT and echocardiography were also excellent (all r=0.83, p<0.0001). LVEF was similar with 201T1-gated SPECT and echocardiography, but EDV and ESV were significantly higher with echocardiography (p<0.05). Our study revealed that 201T1-gated SPECT has high repeatability and excellent correlation with echocardiography for the assessment of LVEF and volumes in Taiwanese. These results support the clinical application of gated SPECT in routine 201T1 myocardial perfusion imaging in Taiwanese.

並列關鍵字

thallium-201 ejection fraction gated SPECT echocardiography

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