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1.
EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology 总被引:7,自引:7,他引:0
Hesse B Tägil K Cuocolo A Anagnostopoulos C Bardiés M Bax J Bengel F Busemann Sokole E Davies G Dondi M Edenbrandt L Franken P Kjaer A Knuuti J Lassmann M Ljungberg M Marcassa C Marie PY McKiddie F O'Connor M Prvulovich E Underwood R van Eck-Smit B;EANM/ESC Group 《European journal of nuclear medicine and molecular imaging》2005,32(7):855-897
The European procedural guidelines for radionuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radiopharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation-scatter compensation, data analysis, reports and image display, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocardial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocardial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness. 相似文献
2.
Myocardial perfusion scintigraphy: the evidence 总被引:16,自引:6,他引:10
Underwood SR Anagnostopoulos C Cerqueira M Ell PJ Flint EJ Harbinson M Kelion AD Al-Mohammad A Prvulovich EM Shaw LJ Tweddel AC;British Cardiac Society;British Nuclear Cardiology Society;British Nuclear Medicine Society;Royal College of Physicians of London;Royal College of Radiologists 《European journal of nuclear medicine and molecular imaging》2004,31(2):261-291
This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by comparison with the numbers of revascularisations and coronary angiograms performed. Furthermore, MPS activity levels in this country fall far short of those in comparable European countries, with about half as many scans being undertaken per year. Currently, the number of MPS studies performed annually in the UK is 1,200/million population/year. We estimate the real need to be 4,000/million/year. The current average waiting time is 20 weeks and we recommend that clinically appropriate upper limits of waiting time are 6 weeks for routine studies and 1 week for urgent studies.Abbreviations Acc
Diagnostic accuracy
- ACS
Acute coronary syndromes
- BCS
British Cardiac Society
- BNCS
British Nuclear Cardiology Society
- BNMS
British Nuclear Medicine Society
- CABG
Coronary artery bypass grafting
- CHD
Coronary heart disease
- CT
Computed X-ray tomography
- LBBB
Left bundle branch block
- MI
Myocardial infarction
- MIBI
Technetium-99m 2-methoxy-isobutyl-isonitrile
- MPS
Myocardial perfusion scintigraphy
- NSF
National Service Framework for Cardiovascular Disease
- NSTEMI
Non-ST segment elevation myocardial infarction
- PCI
Percutaneous coronary intervention
- Q
Quantitative analysis
- QALY
Quality-adjusted life-year
- RCP
Royal College of Physicians of London
- RCR
Royal College of Radiologists
- Sens
Sensitivity
- Spec
Specificity
- SPET
Single-photon emission tomography
- STEMI
ST segment elevation myocardial infarction
- Tetro or tetrofosmin
Technetium-99m 1,2-bis[bis(2-ethoxyethyl) phosphino] ethane
- 201Tl or thallium
Thallium-201 thallous chloride
- UA
Unstable angina
- V
Visual analysis 相似文献
3.
?zlem L. Kapucu Flavio Nobili Andrea Varrone Jan Booij Thierry Vander Borght Kjell N?gren Jacques Darcourt Klaus Tatsch Koen J. Van Laere 《European journal of nuclear medicine and molecular imaging》2009,36(12):2093-2102
These guidelines summarize the current views of the European Association of Nuclear Medicine Neuroimaging Committee (ENC).
The purpose of the guidelines is to assist nuclear medicine practitioners when making recommendations, performing, interpreting,
and reporting the results of brain perfusion single photon emission computed tomography (SPECT) studies using 99mTc-labelled radiopharmaceuticals. The aim is to achieve a high quality standard for brain perfusion SPECT imaging, which will
increase the diagnostic impact of this technique in clinical practice. The present document replaces a former version of the
guideline published in 2001 which was inspired by the Society of Nuclear Medicine Procedure Guideline for Brain Perfusion
SPECT [1], the views of the Society of Nuclear Medicine Brain Imaging Council [2], and the individual experience of experts in European countries. The guidelines are intended to present information specifically
adapted to European practice. The information provided should be taken in the context of local conditions and regulations. 相似文献
4.
R. Parker Ward Mouaz H. Al-Mallah Gabriel B. Grossman Christopher L. Hansen Robert C. Hendel Todd C. Kerwin Benjamin D. McCallister Rupa Mehta Donna M. Polk Peter L. Tilkemeier Aseem Vashist Kim Allan Williams David G. Wolinsky Edward P. Ficaro 《Journal of nuclear cardiology》2007,14(6):e26-e38
Conclusion The ACCF/ASNC AC for SPECT MPI provides recommendations for the appropriate use of SPECT MPI. After the publication of the
AC document in 2005, the AC has been used by nuclear cardiology practices with many clinical studies evaluating the list of
indications in routine clinical practice. From these data. ASNC recommends minor but important changes to the indication list,
suggesting the addition of 6 new indications and the modification of the definitions for “chest pain syndrome” and “CHD high
risk.”. An objective review of existing indications focused on only those indications that had significant variability among
the reviewers (n=20). These indications were reviewed in the presence of existing and new evidence-based data, and ASNC recommends
that the grades for 6 indications be re-evaluated.
The AC for SPECT MPI will require periodic review as new evidence becomes available or as clinical practice evolves. ASNC
recognizes the importance of these criteria to improve the quality of patient care, and it will continue to play a key role
in assembling the information for this ongoing review. From the current summary of evidence, ASNC consensus opinions, and
ASNC recommendations in this document, ASNC strongly recommends that the AC guidelines be reviewed
Prepared by the American Society of Nuclear Cardiology Quality Assurance Subcommittee for Quality in Imaging Standards.
Reviewed by members of the American Society of Nuclear Cardiology Quality Assurance Committee.
Approved by the American Society of Nuclear Cardiology Board of Directors, September 6, 20. 相似文献
5.
Daniel S. Berman MD Xingping Kang MD Heidi Gransar MS James Gerlach CNMT John D. Friedman MD Sean W. Hayes MD Louise E. J. Thomson MBChB Rory Hachamovitch MD MSc Leslee J. Shaw PhD Piotr J. Slomka PhD Ling De Yang MD Guido Germano PhD 《Journal of nuclear cardiology》2009,16(1):45-53
Background Current guidelines of Food and Drug Administration for the evaluation of SPECT myocardial perfusion imaging (MPI) in clinical
trials recommend independent visual interpretation by multiple experts. Few studies have addressed whether quantitative SPECT
MPI assessment would be more reproducible for this application.
Methods and Results We studied 31 patients (age 68 ± 13, 25 male) with abnormal stress MPI who underwent repeat exercise (n = 11) or adenosine
(n = 20) MPI within 9-22 months (mean 14.9 ± 3.8 months) and had no interval revascularization or myocardial infarction and
no change in symptoms, stress type, rest or stress ECG, or clinical response to stress on the second study. Visual interpretation
per FDA Guidance used 17-segment, 5-point scoring by two independent expert readers with overread of discordance by a third
expert, and percent myocardium abnormal was derived from normalized summed scores. The quantitative magnitude of perfusion
abnormality was assessed by the total perfusion deficit (TPD), expressing stress, rest, and ischemic perfusion abnormality.
High linear correlations were observed between visual and quantitative size of stress, rest, and ischemic defects (R = 0.94, 0.92, 0.84). Correlations of two tests were higher by quantitative than by visual methods for stress (R = 0.97 vs R = 0.91, P = 0.03) and rest defects (R = 0.94 vs R = 0.82, P = 0.03), respectively, and statistically similar for ischemic defects (R = 0.84 vs R = 0.70, P = ns).
Conclusions In stable patients having serial SPECT MPI, quantification is more reproducible than visual for magnitude of perfusion abnormality,
suggesting its superiority for use in randomized clinical trials and monitoring the effects of therapy in an individual patient.
See related editorial, doi:
This study was presented in part at the Society of Nuclear Medicine 55th Annual Meeting, New Orleans, Louisiana, June 14-18,
2008. 相似文献
6.
Taqueti Viviany R. Dorbala Sharmila Wolinsky David Abbott Brian Heller Gary V. Bateman Timothy M. Mieres Jennifer H. Phillips Lawrence M. Wenger Nanette K. Shaw Leslee J. 《Journal of nuclear cardiology》2017,24(4):1402-1426
Journal of Nuclear Cardiology - This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging... 相似文献
7.
Katsikis Athanasios Theodorakos Athanasios Kouzoumi Anna Kitziri Elpida Georgiou Evangelos Koutelou Maria 《Journal of nuclear cardiology》2017,24(4):1314-1327
Journal of Nuclear Cardiology - We attempted to validate the performance of a fast myocardial perfusion imaging (MPI) protocol in diagnostically challenging patients. 78 patients with... 相似文献
8.
Kunita Yuji Nakajima Kenichi Nakata Tomoaki Kudo Takashi Kinuya Seigo 《Annals of nuclear medicine》2022,36(7):674-683
Annals of Nuclear Medicine - Selecting patients with coronary multivessel disease (MVD) or no stenosis using myocardial perfusion imaging (MPI) is challenging. We aimed to create a model to predict... 相似文献
9.
Kenichi Nakajima Shinro Matsuo Masaya Kawano Naoya Matsumoto Jun Hashimoto Keiichiro Yoshinaga Junichi Taki Koichi Okuda 《Annals of nuclear medicine》2010,24(2):99-105
Purpose
The Japanese Society of Nuclear Medicine (JSNM) working group has created a myocardial perfusion imaging database applicable to standard acquisition protocol. The aim of this study is to validate the diagnostic accuracy of the common normal database compared with the expert interpretation of each institute. 相似文献10.
Jacques Darcourt Jan Booij Klaus Tatsch Andrea Varrone Thierry Vander Borght Özlem L. Kapucu Kjell Någren Flavio Nobili Zuzana Walker Koen Van Laere 《European journal of nuclear medicine and molecular imaging》2010,37(2):443-450
These guidelines summarize the current views of the European Association of Nuclear Medicine Neuroimaging Committee (ENC). The aim of the guidelines is to assist nuclear medicine practitioners when making recommendations, performing, interpreting, and reporting the results of clinical dopamine transporter (DAT) single photon emission computed tomography (SPECT) studies using 123I-labelled radiopharmaceuticals. The aim is to achieve a high-quality standard of DAT SPECT imaging, which will increase the diagnostic impact of this technique in neurological practice. The present document is an update of the 2002 guidelines [1] and has been guided by the views of various national societies: the Task Group Neuro-Nuclear-Medicine of the German Society of Nuclear Medicine [2], a consensus statement of the imaging centres included in the “Kompetenznetz-Parkinson” sponsored by the German Federal Ministry of Education, and the Task Group of Neuro-Nuclear-Medicine of the French Society of Nuclear Medicine [3]. The guidelines reflect the individual experience of experts in European countries. The guidelines are intended to present information specifically adapted to European practice. The information provided should be taken in the context of local conditions and regulations. 相似文献
11.
Eliana Reyes 《Journal of nuclear cardiology》2016,23(3):447-453
Caffeine is a non-selective antagonist at the adenosine receptors, which is expected to reverse both the intended (coronary vasodilation) and unintended (hypotension, flushing) effects of exogenously administered adenosine and adenosine-related compounds. In the past, several studies were conducted to characterize the effect of caffeine on vasodilator myocardial perfusion imaging (MPI) with conflicting results. However, new evidence supports earlier observations and shows that recent caffeine intake attenuates vasodilator-induced myocardial hyperaemia and may therefore reduce the sensitivity of radionuclide MPI for the detection of inducible perfusion abnormality in patients with coronary artery disease. Although the magnitude of this effect and hence its clinical significance are dose dependent, the acute response to equivalent doses of caffeine varies largely among individuals, and this might be explained by differences in caffeine exposure and genetically determined variations in caffeine metabolism. Abstinence from caffeinated foods and beverages for a minimum of 12 hours before vasodilator stress is therefore recommended although longer abstention might be required in order to prevent the potentially blocking effect of residual caffeine on vasodilator-mediated actions. 相似文献
12.
American society of nuclear cardiology position statement on electrocardiographic gating of myocardial perfusion SPECT scintigrams 总被引:5,自引:0,他引:5
Timothy M. Bateman Daniel S. Berman Gary V. Heller Kenneth A. Brown Manuel D. Cerqueira Mario S. Verani James E. Udelson Dawn Edgerton 《Journal of nuclear cardiology》1999,6(4):470-471
Conclusion In heart transplant recipients with isolated focal CAD involving the proximal or mid portion of a vessel, revascularization
options exist. However, because of the increased risk of the procedure and uncertain impact on outcome, it probably is important
to document evidence of provokable ischemia, especially if the patient is symptom free. Stress myocardial perfusion imaging
can document ischemia related to specific coronary artery lesions and may be an important adjunct to decision making in this
difficult patient population.
One of the most important recent developments in single photon emission computed tomography (SPECT) myocardial perfusion imaging
is the ability to acquire these studies in conjunction with electrocardiogrpahic (ECG) gating. A recommendation for incorporating
ECG gating as a routine during SPECT cardiac perfusion scintigraphy is appropriate for at least four reasons: there is extensive
peer-reviewed literature attesting to its value; the practice is now widespread; practitioners in diverse settings (academia
dn private practive) regularly use it; and the hardware and software requirements are widely available. In addition, ASNC-sponsored
continuing medical education programs for the past several years have emphasized the added information provided by ECG gating.
The purpose of this position statemetn therefore is to formally encourage routine ECG gating along with SPECT myocardial perusion
studies, unless technical reasons preclude this. p ]Although the principleis clear-cut, there will need to be more investigations
and, ultimately, procedural guidelines to assist in optimizing acquisition and processing parametes in relation to different
hardware and radiopharmaceuticals. This is a first step in a new and expanding direction for myocardial perfusion scintigraphy.
Timothy M. Bateman, MD President American Society of Nuclear Cardiology 相似文献
13.
Robert J. Golub Joseph R. McClellan Steven D. Herman Mark I. Travin Gregory M. Kline Percy W. Aitken John I. Baron Alan W. Ahlberg Gary V. Heller 《Journal of nuclear cardiology》1996,3(2):114-118
Background
To evaluate the effectiveness of published nuclear cardiology training guidelines, the diagnostic accuracy of image interpretation by nuclear cardiology trianees was compared with that of experienced nuclear cardiologists.Methods and Results
The accuracy of three experienced nuclear cardiologists and three trainees with level II experience following Society of Nuclear Medicine/American College of Cardiology/American Society of Nuclear Cardiology guidelines in the interpretation of 114 exercise 99mTc-labeled sestamibi single-photon emission computed tomographic imaging studies was evaluated. Studies were selected randomly and included patients with less than 5% likelihood of coronary artery disease, as well as patients with angiographically demonstrated single and multivessel disease. Studies were interpreted by each reader without knowledge of clinical or exercise data. Each reader classified perfusion as normal or abnormal. Accuracy was assessed according to sensitivity, normalcy rate, and predictive accuracy. In addition, the ability of experienced readers and trainees to identify abnormal perfusion in patients with multivessel disease was compared. Trainees had high accuracy, comparable to experienced readers for sensitivity, normalcy rate, and predictive accuracy, as well as the ability to identify abnormal perfusion in patients with multivessel disease. In all categories, experienced interpretors demonstrated a trend toward greater accuracy with less observer variability than did trainees.Conclusion
Structured training in nuclear cardiology following Society of Nuclear Medicine/American College of Cardiology/American Society of Nuclear Cardiology guidelines during clinical cardiology fellowship is effective, and trainees possess the skills to interpret myocardial perfusion images accurately. Interpretive skills can be expected to improve further with experience. 相似文献14.
Sobic-Saranovic DP Pavlovic SV Artiko VM Obradovic VB 《Hellenic journal of nuclear medicine》2011,14(3):284-290
Several techniques have been applied for the assessment of severe congenital heart diseases (SCHD) including echocardiography, cardiac catheterization with angiocardiography, and more recently, cardiovascular multi detector tomography and magnetic resonance imaging (MRI). The value of gated single photon emission tomography (GSPET) myocardial perfusion imaging (MPI) and radionuclide ventriculography (RNV) for evaluating myocardial ischemia, tissue viability, and left ventricular function in SCHD is less apparent. The risk of radiation exposure is greatest in the youngest patients. Both, GSPET MPI and RNV seem to be underutilized in pediatric clinical practice due to increased radiation exposure. We have reviewed basic and specific technical and diagnostic aspects, as well as specific clinical indications of GSPET MPI and RNV in children with SCHD in comparison with other cardiology methods. Some of our own tests are also presented where they apply. In conclusion, GSPET MPI and RNV can provide clinical relevant information of functional significance of SCHD in pediatric patients especially when the other cardiology methods are indeterminate. With regard to radiation exposure appropriate patient selection and recommendations for reduction of radiation exposure are of great importance. 相似文献
15.
Florian Schwarz Balazs Ruzsics U. Joseph Schoepf Gorka Bastarrika Salvatore A. Chiaramida Joseph A. Abro Robin L. Brothers Sebastian Vogt Bernhard Schmidt Philip Costello Peter L. Zwerner 《European journal of radiology》2008
The introduction of coronary CT angiography (cCTA) has reinvigorated the debate whether management of patients with suspected coronary artery disease (CAD) should be primarily based on physiological versus anatomical testing. Anatomical testing (i.e., cCTA or invasive catheterization) enables direct visualization and grading of coronary artery stenoses but has shortcomings for gauging the hemodynamic significance of lesions for myocardial perfusion. Conversely, rest/stress myocardial perfusion imaging (MPI) has been extensively validated for assessing the clinical significance of CAD by demonstrating fixed or reversible perfusion defects but has only limited anatomical information. There is early evidence that contrast medium enhanced dual-energy cCTA (DECT) has potential for the comprehensive analysis of coronary artery morphology as well as changes in myocardial perfusion. DECT exploits the fact that tissues in the human body and iodine-based contrast media have unique absorption characteristics when penetrated with different X-ray energy levels, which enables mapping the iodine (and thus blood) distribution within the myocardium. The purpose of this communication is to describe the practical application of this emerging technology for the comprehensive diagnosis of coronary artery disease in the context of the currently used tomographic imaging modalities (cCTA, nuclear MPI, MR MPI). 相似文献
16.
《European journal of radiology》2009,69(3):423-433
The introduction of coronary CT angiography (cCTA) has reinvigorated the debate whether management of patients with suspected coronary artery disease (CAD) should be primarily based on physiological versus anatomical testing. Anatomical testing (i.e., cCTA or invasive catheterization) enables direct visualization and grading of coronary artery stenoses but has shortcomings for gauging the hemodynamic significance of lesions for myocardial perfusion. Conversely, rest/stress myocardial perfusion imaging (MPI) has been extensively validated for assessing the clinical significance of CAD by demonstrating fixed or reversible perfusion defects but has only limited anatomical information. There is early evidence that contrast medium enhanced dual-energy cCTA (DECT) has potential for the comprehensive analysis of coronary artery morphology as well as changes in myocardial perfusion. DECT exploits the fact that tissues in the human body and iodine-based contrast media have unique absorption characteristics when penetrated with different X-ray energy levels, which enables mapping the iodine (and thus blood) distribution within the myocardium. The purpose of this communication is to describe the practical application of this emerging technology for the comprehensive diagnosis of coronary artery disease in the context of the currently used tomographic imaging modalities (cCTA, nuclear MPI, MR MPI). 相似文献
17.
Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial perfusion imaging 总被引:1,自引:1,他引:0
Prem Soman MD PhD FRCP Avijit Lahiri MD Jennifer H. Mieres MD Dennis A. Calnon MD David Wolinsky MD George A. Beller MD Tina Sias MD Kenneth Burnham MD Laurence Conway MD Peter A. McCullough MD Edouard Daher MD Mary N. Walsh MD Joseph Wight MD Gary V. Heller MD PhD James E. Udelson MD 《Journal of nuclear cardiology》2009,16(1):82-91
Objective The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission
computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized
with new-onset heart failure.
Methods We recruited 201 patients (age 65.3 ± 14.5 years, 43% women) hospitalized with their first episode of heart failure. Rest/stress
gated SPECT Tc-99m sestamibi MPI was performed during or within 2 weeks of the index hospitalization, in addition to standard
care.
Results SPECT MPI revealed a broad range of ejection fractions with preserved systolic function in 36% of patients. Forty-one percent
of patients had normal perfusion. In the remaining patients, perfusion abnormalities were predominantly due to prior myocardial
infarction, with extensive ischemia seen only in 6%. Among patients who underwent coronary angiography, SPECT performance
characteristics revealed excellent negative predictive value (96%) for extensive coronary artery disease (CAD). In multivariable
analyses, the extent of perfusion abnormality and advancing age predicted the presence of extensive CAD.
Conclusions These preliminary data derived from a non-randomized observational cohort suggest potential diagnostic utility of MPI for
ischemic LV dysfunction in new-onset HF, and sets the stage for a prospective randomized study to confirm these findings.
The results were presented in part at the 2004 Annual Scientific Sessions of the American Society of Nuclear Cardiology, and
the American College of Cardiology. 相似文献
18.
核素心肌显像在冠心病处理决策中的合理应用及其原理 总被引:1,自引:0,他引:1
李殿富 《国际放射医学核医学杂志》2004,28(2):56-59
核素心肌显像在冠心病诊断、危险度分层及预后判断方面积累了大量资料,并可据此制定冠心病的有效处理策略。在ACC/AHA(美国心脏病学会/美国心脏协会)有关冠心病和核心脏病学指南中,核素心肌显像的上述作用得到了充分肯定。合理应用该技术可以提高我们对冠心病诊断处理的整体水平,并使有限的医疗资源得到更合理利用,目前这在我国显得十分迫切和必要。 相似文献
19.
Kondo C 《Annals of nuclear medicine》2004,18(7):551-561
Myocardial perfusion imaging (MPI) is an important procedure in pediatric cardiology in terms of evaluating myocardial ischemia, infarction and damage associated with various congenital or acquired heart diseases, such as Kawasaki disease, anomalous origin of the left coronary artery from the pulmonary artery and complete transposition of the great arteries after arterial switch surgery. This type of imaging can detect myocardial damage in the morphological right ventricle when it functions as a systemic pumping chamber in patients with complex congenital heart diseases after intra-cardiac repair. Myocardial perfusion imaging can also evaluate myocardial damage associated with primary or secondary cardiomyopathy in children. The magnitude of increased right ventricular uptake on MPI is a useful noninvasive means of estimating right ventricular pressure overload due to congenital heart or pulmonary diseases. This article reviews myocardial perfusion tracers and pharmacological stress tests used to diagnose heart conditions in children, and the current clinical roles of MPI in pediatric cardiology. 相似文献
20.
Rubidium-82 (82Rb), the currently commercially available radiotracer for positron emission tomography (PET) myocardial perfusion imaging (MPI), has led to wide availability of PET-MPI for stress-rest imaging. Compared to SPECT MPI, myocardial perfusion PET images have higher spatial and contrast resolution, are less affected by radiotracer scatter, benefit from more precise attenuation correction, and allow dynamic first pass imaging. In addition, PET imaging allows assessment of myocardial function at peak stress and measurement of absolute myocardial blood flow, thus providing critical data not available with SPECT imaging. Further enhancements of the high quality of PET perfusion images may be realized by technologies under development such as respiratory gating, combined respiratory, and ECG gating to generate “motion-frozen” cardiac images, automated patient motion correction software, and high-definition PET, which reduces distortions introduced by the circular geometry of the scanner. Early studies indicate that the experimental PET radiopharmaceutical flurpiridaz F 18 provides high-quality, high-resolution myocardial perfusion images that may enable improved clinical MPI, and has properties well suited to optimized performance by application of these quantitative analytic technologies. 相似文献