新型碲-锌-镉单光子发射断层显像仪检测心力衰竭左心室机械收缩失同步研究

摘要

Objective The aim of this study was to evaluate left ventricular systolic asynchronization in patients with heart failure by gated myocardial perfusion imaging (GMPI)using Cadmium-Zinc-Telluride (CZT) single photon emission computed tomography(SPECT),and compare with conventional SPECT myocardial perfusion imaging(MRI) and positron emission tomography(PET) assessment.Methods Thirty-five consecutive patients with heart failure were recruited from July to October 2016 in Fuwai hospital.All patients underwent CZT SPECT GMPI,conventional SPECT GMPI,PET and cardiac MRI within 7 days.Bind width(BW) and standard deviation (SD)were calculated by three nuclear medicine imaging modalities.Results CZT SPECT GMPI showed good correlation respectively for BW(r =0.833,P＜0.001)and SD(r =0.795,P＜0.001)with conventional SPECT GMPI.CZT SPECT GMPI also showed a good correlation respectively for BW (r =0.914,P＜0.001)and SD(r=0.804,P＜0.001)with PET.Bland-Altman analysis revealed good agreement of BW and SD between CZT SPECT and PET.Bland-Altman analysis showed systematic underestimation of BW and SD with conventional SPECT GMPI compared with CZT SPECT and PET.Conclusion CZT SPECT GMPI with minimal acquisition time provides the left ventricular dyssynchrony parameters that correlated well and had good agreement with PET,and has the high value of clinical application in patients with heart failure.%目的 应用碲-锌-镉单光子发射断层显像仪(CZT SPECT)进行门控心肌灌注显像(GM-PI),对心力衰竭患者进行左心室机械收缩失同步评价,并与常规单光子发射计算机断层(SPECT)心肌灌注显像和正电子断层显像(PET)心肌代谢显像进行比较.方法 入选中国医学科学院阜外医院2016年7月～l0月连续35例心力衰竭患者,先后进行CZT SPECT、常规SPECT门控心肌灌注显像及门控PET心肌代谢显像,分别检测左心室相位带宽(BW)和相位标准差(SD).结果 CZT SPECT GMPI测得的BW(r=0.833,P＜0.001)和SD(r=0.795,P＜0.001)与常规SPECT的估测结果均有很好的相关性.CZT SPECT GMPI测得的BW(r=0.914,P＜0.001)和SD(r=0.804,P＜0.001)与PET的估测结果亦均有很好的相关性.Bland-Altman分析结果显示:CZT SPECT与PET测得的BW和SD均有较好的一致性.与CZT SPECT及PET测得结果比较,常规SPECT略低估BW和SD.结论 CZT SPECT虽然采集时间明显缩短,但在检测心力衰竭患者左心室机械收缩失同步方面,与常规SPECT和PET均有较好的相关性和相对接近的一致性,因此有显著的临床应用价值.