| CT衰减校正对IQ-SPECT/CT和LEHR-SPECT/CT心肌灌注显像的影响 |
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| 引用本文： | 卫华,薛及弟,武志芳,张磊,胡光,王进. CT衰减校正对IQ-SPECT/CT和LEHR-SPECT/CT心肌灌注显像的影响[J]. 国际放射医学核医学杂志, 2020, 44(7): 405-410. DOI: 10.3760/cma.j.cn121381-201903062-00054 |
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| 作者姓名： | 卫华 薛及弟 武志芳 张磊 胡光 王进 |
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| 作者单位： | 山西医科大学第一医院核医学科，太原 030001 |
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| 摘 要： | 目的 探讨CT衰减校正（CTAC）对智能（IQ）-SPECT/CT和低能高分辨率（LEHR）-SPECT/CT心肌血流灌注显像（MPI）图像的影响。 方法 收集2018年5月至10月在山西医科大学第一医院行静息心肌灌注显像（MPI）的31例确诊或者可疑的冠心病患者，其中男性21例、女性10例，年龄（49.4±12.01）岁。所有患者同日分别行IQ-SPECT/CT+CTAC及LEHR-SPECT/CT+CTAC。视觉分析IQ-SPECT/CT CTAC前后图像及手动配位后图像、LEHR-SPECT/CT CTAC前后断层图像；同时比较左心室各个室壁（心尖、前壁、侧壁、间壁、下壁）IQ-SPECT/CT和LEHR-SPECT/CT CTAC前后与重新配位后的放射性摄取值（%）。两组间比较采用配对t检验，率的比较采用卡方检验，一致性分析采用Kappa检验。 结果 ①视觉分析:IQ-SPECT/CT与LEHR-SPECT/CT CTAC前图像比较，具有很高的一致性（Kappa值=0.795，P<0.001）。IQ-SPECT/CT CTAC后心肌节段出现放射性分布明显稀疏的比例为77%（24/31），远高于LEHR- SPECT/CT CTAC后的23%（7/31），差异有统计学意义（χ2=16.52，P<0.001）。将MPI与CT图像手动重新配位后，IQ-SPECT/CT左心室心尖的放射性分布为16%（5/31），与LEHR-SPECT/CT的23%（7/31）相比，差异无统计学意义（χ2=0.103，P=0.748）。②放射性摄取值（%）:IQ-SPECT/CT CTAC前后比较，左心室心尖[（65.71±25.69）%对（58.68±20.39）%]、前壁[（204.23±43.24）%对（184.66±41.22）%]及间壁[（316.19±47.43）%对（270.03±65.33）% ] 的放射性摄取值明显降低，且差异均有统计学意义（t=4.014、4.232、5.473，均P<0.05）；LEHR-SPECT/CT CTAC前后比较，左心室前壁[（204.68±41.14）%对[（211.81±35.04）%]、间壁[（319.13±44.90）%对（350.87±44.24）%]及下壁[（185.48±31.06）%对（228.67±29.45）% ]的放射性摄取值显著增高，且差异均有统计学意义（t=?2.471，P =0.019；t=?5.968，P<0.001；t=?11.311，P<0.001）。IQ-SPECT/CT CTAC配位后与IQ-SPECT/CT CTAC前比较，左心室前壁[（212.06±33.59）%对（204.23±43.24）%]、侧壁[（372.84±39.37）%对（355.81±46.79）%]、下壁[（219.13±25.10）%对（191.58±33.06）%]和间壁[（335.00±36.84）%对（316.19±47.43）%]的放射性摄取值均明显增高，且差异均有统计学意义（t=?2.497，P=0.018；t=?2.672，P=0.012；t=?7.632，P<0.001；t=?3.557，P<0.001） 。 结论 LEHR-SPECT/CT CTAC后左心室间壁及下壁的放射性分布得到补偿；而IQ-SPECT/CT CTAC后左心室心尖、前壁及间壁的放射性分布却更加稀疏。在IQ-SPECT/CT采集模式下，CTAC后容易出现矫枉过正，重新手动配位后这种情况将得到明显改善。
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| 关 键 词： | 体层摄影术，发射型计算机，单光子 体层摄影术，X线计算机 衰减校正 心肌灌注显像 |
| 收稿时间： | 2019-03-30 |
Effect of CT attenuation correction on IQ-SPECT/CT and LEHR-SPECT/CT myocardial perfusion imaging |
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| Hua ?Wei,Jidi Xue,Zhifang Wu,Lei Zhang,Guang Hu,Jin Wang. Effect of CT attenuation correction on IQ-SPECT/CT and LEHR-SPECT/CT myocardial perfusion imaging[J]. International Journal of Radiation Medicine and Nuclear Medicine, 2020, 44(7): 405-410. DOI: 10.3760/cma.j.cn121381-201903062-00054 |
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| Authors: | Hua ?Wei Jidi Xue Zhifang Wu Lei Zhang Guang Hu Jin Wang |
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| Affiliation: | Department of Nuclear Medicine, the First Hospital of Shanxi Medical University, Taiyuan 030001, China |
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| Abstract: | Objective To evaluate the impact of CT attenuation correction (CTAC) on intelligence quotient (IQ)-SPECT/CT and low energy high resolution (LEHR)- SPECT/CT myocardial perfusion imaging (MPI). Methods Thirty-one patients (21 males and 10 females, aged 49.4 ± 12.01 years) with confirmed or suspected coronary heart disease were subjected to resting MPI from May 2018 to Octorber 2018 in the First Hospital of Shanxi Medical University. All patients were subjected to IQ-SPECT/CT+CTAC and LEHR-SPECT/CT+CTAC on the same day. The visual analysis and myocardial uptake of five myocardial segments (apical, anterior, lateral, inferior, and septal walls) were compared before and after IQ-SPECT/CT CTAC and after manual coordination, as well as before and after LEHR-SPECT/CT CTAC. Paired t test was used for comparison between the two groups. Chi-square test was used to compare the rate. Kappa test was used for consistency analysis. Results (1) Visual analysis results were as follows. The IQ group was compared with the LEHR group without CTAC. Two nuclear medicine physicians were double blind and had high agreement (Kappa value = 0.795, P<0.001). The sparse rate of myocardial segments of the IQ group was 77% (24/31), which was much higher than that of the LEHR group by 23% (7/31) ( χ2=16.52, P<0.001). Owing to the high sparse rate myocardial segments of IQ, the original image and manual reregistration the MPI and CT images were analyzed. After re-coordination, the distribution of apical in the IQ group was found to be sparse (16%, 5/31), and the difference between the LEHR group (23%, 7/31) was not statistically significant (χ2=0.103, P=0.748). (2) Results of myocardial uptake were as follows. Compared with the previous IQ-CTAC, the myocardial uptake values of the apical wall [(65.71±25.69)% vs.(58.68±20.39)%], anterior wall[ (204.23±43.24)% vs.(184.66±41.22)%], and septal wall [ (316.19±47.43)% vs. (270.03±65.33)% ] significantly decreased after CTAC(t=4.014, 4.232, and 5.473, respectively; all P<0.05). Meanwhile, myocardial uptake increased in anterior wall [ (204.68±41.14) % vs. (211.81±35.04)%], septal wall[ (319.13±44.90)% vs.( 350.87±44.24)%], and inferior wall [(185.48±31.06)% vs.( 228.67±29.45)% ] of the LEHR group after CTAC(t=?2.471, P=0.019; t=?5.968, P<0.001; and t=?11.311, P<0.001, respectively). After IQ registration, compared with previous CTAC, the myocardial uptake values of anterior wall [(212.06±33.59)% vs. (204.23±43.24)%], lateral wall [(372.84±39.37)% vs. (355.81±46.79)%], inferior wall [(219.13±25.10)% vs. (191.58±33.06)%], and septal wall [(335.00±36.84)% vs. (316.19±47.43)%] obviously increased (t=?2.497, P=0.018; t=2.672, P=0.012; t=?7.632, P<0.001 and t=?3.557, P<0.001, respectively). Conclusions The distribution of inferior and inferior walls of LEHR-SPECT/CT CTAC was compensated, whereas the distribution of apical, anterior, and septal walls became sparse after IQ-SPECT/CT CTAC. In the IQ-SPECT/CT acquisition mode, overcorrection likely occurred after CTAC, and this situation was significantly improved after re-coordination. |
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