滤波反投影法和OSEM重建图像测量心功能参数的比较

摘要

目的 比较静息门控心肌显像滤波反投影法(FBP)和OSEM重建图像后用定量门控心肌断层显像(QGS)、四维模型心肌断层显像(4D-MSPECT)、爱莫瑞心脏工具箱(ECToolbox)软件测量的心功能参数.方法 临床疑诊或确诊冠心病患者144例,均行99Tcm-MIBI静息门控心肌SPECT显像,所有患者均用FBP和OSEM重建图像,用QGS、4D-MSPECT、ECToolbox软件计算心功能参数LVEF,EDV和ESV,采用Bland-Altman法检验2种重建方法的一致性,配对t检验方法检验心功能参数差异,相关性分析用直线回归分析.结果 FBP和OSEM重建测量的心功能参数一致性和相关性好(r均>0.93,P均<0.001).QGS软件FBP重建测得的EDV低于OSEM重建测得的EDV,其他2种软件为FBP高于OSEM[QGS:(82.2±39.1) ml和(83.5±40.8) ml,t=-2.53,P<0.05;4D-MSPECT:(93.5±46.9) ml和(88.8±45.2) ml,t=5.95,P<0.01;ECToolbox:(106.4±51.1) ml和(100.8±49.0) ml,t=3.99,P<0.01].对于ESV,4D-MSPECT软件FBP测量值高于OSEM [(37.5±41.4) ml和(34.8±37.6) ml,t=3.92,P<0.01].QGS软件FBP测得的LVEF低于OSEM测得的LVEF [(62.1±16.9)%和(63.1±16.1)%,t=-3.14,P<0.01].ECToolbox软件FBP测得的LVEF高于用OSEM测得的LVEF[(74.1±18.8)%和(71.3±17.1)%,t=5.28,P<0.01].结论 2种重建方法所测量的心功能参数虽然相关性和一致性很好,但某些参数值差异有统计学意义.%Objective To compare the cardiac function parameters in gated SPECT determined by filtered back projection (FBP) and OSEM reconstruction methods. Methods One hundred and forty-four patients underwent 99Tcm-MIBI gated-SPECT imaging studies. The parameters LVEF, EDV and ESV, were derived using quantitative gated SPECT (QGS), four-dimensional model SPECT (4D-MSPECT) and emory cardiac toolbox (ECToolbox) softwares. Each image was reconstructed by FBP or OSEM. Bland-Altman analysis and paired t-test were applied to evaluate those parameters. Results Correlation coefficients for LVEF, EDV and ESV between FBP and OSEM methods were all more than 0.93 (all P<0.001). EDV calculated by FBP was lower than that by OSEM using QGS software, but became the opposite when using 4D-MSPECT and ECToolbox softwares. (QGS: (82.2±39.1) ml vs (83.5±40.8) ml, t=-2.53, P<0.05; 4D-MSPECT: (93.5±46.9) ml vs (88.8±45.2) ml, t=5.95, P<0.01; ECToolbox: (106.4±51.1) ml vs (100.8±49.0) ml, t=3.99, P<0.01). ESV calculated by FBP was higher than that by OSEM using 4D-MSPECT software (4D-MSPECT:(37.5±41.4) ml vs (34.8±37.6) ml, t=3.92, P<0.01). LVEF calculated by FBP was lower than that by OSEM using QGS software ((62.1±16.9)% vs (63.1±16.1)%, t=-3.14, P<0.05), but higher than that by OSEM using ECToolbox software ((74.1±18.8)% vs (71.3±17.1)%, t=5.28, P<0.01). Conclusion Generally, cardiac functional parameters based on FBP and OSEM construction methods correlated well, although they might have singnificantly different results.