不同门控心肌灌注显像测量左心室功能的准确性研究

目的:比较分析8帧和16帧门控心肌灌注显像(GMPI)测量左室功能的准确性。方法:选取在医院就诊的86例拟行GMPI检查的患者,所有患者同时行8帧GMPI和16帧GMPI图像采集和重建处理,比较两者的左心室舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、高峰充盈率(PFR)、高峰充盈率时间(TTPF)、1/3最大充盈率(MFR/3)等参数,同时与超声心动图(UCG)检查结果进行比较。结果:8帧和16帧GMPI测量的EDV、ESV、EF、PER及PFR值之间高度相关(r=0.972,r=0.954,r=0.885,r=0.814,r=0.751;P<0.05)。两种帧数GMPI判断PFR正常与否间的符合率为70.9%(Kappa=0.446,P=0.000);以LVEF≥50%为左室收缩功能正常的界值,两种帧数GMPI判断LVEF正常或异常的符合率为70.9%。UCG测量的LVEF值为(64.21±5.74)%,8帧GMPI为(52.15±9.00)%(t=-11.376,P<0.05)。UCG检查LVEF≥50%的65例患者中,8帧GMPI判断LVEF异常的比例为32.3%,显著高于与16帧GMPI(4.6%)(x~2=16.557,P<0.05)。UCG判断左室舒张功能正常的23例中,8帧GMPI和16帧GMPI测量的PFR判断判断为异常的比例分别为60.9%和26.1%(x~2=5.662,P<0.05)。结论:8帧与16帧GMPI测量的左心功能各项结果参数之间具有显著相关性,16帧与8帧相比GMPI测得的左室射血分数及高峰充盈率更准确、更能反映受检者的真实情况。

Study on the accuracies of different G-MPI in measuring the function of left ventricle

Objective:To compare and analyze the accuracies of 8 frames and 16 frames gated myocardial perfusion imaging(GMPI)in measuring function of left ventricle.Methods:Eighty-six patients who prepared to undergo GMPI in Hospital were selected.And all patients underwent simultaneously image acquisition and reconstruction process by 8 frames GMPI and 16 frames GMPI.A series of parameters included left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),ejection fraction(EF),peak filling rate(PFR),peak filling rate time(TTPF),1/3 of maximum filling rate(MFR/3)of the two methods were compared,and then they were compared with the results of ultrasound cardiogram(UCG).Results:There were high correlation in the EDV,ESV,EF,PER and PFR between 8 frames and 6 frames GMPI(r=0.972,r=0.954,r=0.885,r=0.814,r=0.751,P<0.05).The consistency about whether the PFR was normal between the two kinds of frames GMPI was 70.9%(Kappa=0.446,P=0.000).When LVEF≥50%was used as the threshold value of normally left ventricular systolic function,the coincidence rate of judging the normal or abnormal LVEF between 8 frames GMPI and 16 frames GMPI was 70.9%.The LVEF value that was measured by UCG was(64.21±5.74%),and the LVEF value that was measured by 8 frames GMPI was(52.15±9.00)%,and the difference of that between the two methods was significantly(t=-11.376,P<0.05).In 65 patients whose LVEF values of UCG examination were≥50%,the proportion of abnormal LVEF values that were detected by 8 frames GMPI was 32.3%,which was significantly higher than 4.6%of 16 frames GMPI(χ²=16.557,P<0.05).In the 23 cases with normally left ventricular diastolic function who were judged by UCG,the proportions of abnormal PFR values which were judged by the measurement of 8 frames GMPI and 16 frames GMPI were 60.9%and 26.1%,respectively(χ²=5.662,P<0.017).Conclusion:There are significant correlation in these measured results of left ventricular function between 8 frames GMPI and 16 frames GMPI.Compared with 8 frames GMPI,the LVEF and PFR of 16 frames GMPI has more accuracies,and can more reflect the real situation of subjects.