心率波动容许范围的设置对心功能参数及心肌灌注评分的影响

目的探讨心律不齐患者行门控心肌显像时,心率波动容许范围设置的不同对心肌灌注及左心功能参数的影响,为临床选择更适当的心率波动容许范围。方法 28例有明显房颤的患者均行门控心肌灌注显像,在采集之前,设定共行成像采集程序,每个患者设置3组共行成像,心率波动容许范围分别设置为20%、60%、100%。采集所得数据用重建方法Astonish进行重建,并通过QGS软件对重建结果进行显示,获得不同心率波动容许范围设置下的心功能参数如舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)以及心肌血流灌注评分,包括负荷心肌血流灌注评分(SSS)和静息心肌血流灌注评分(SRS),对3组共行成像所得的EDV、ESV、EF、SSS、SRS值进行分析。结果 28例入选患者中,有心肌血流灌注异常者为24例,占纳入总数的85.7%;3组不同心率波动容许范围的EDV、ESV、EF、SSS、SRS值差异均无统计学意义;心率波动容许范围为20%,60%和100%时,平均所用图像采集时间分别为40.5min、25.6min和15.0min。结论心律不齐的患者在做门控心肌灌注显像时,心率波动容许范围设置的大小不同对心功能参数以及心肌血流灌注评分的影响不具有统计学意义,而心率波动容许范围越大,所用采集时间越短。

The influence of heartbeat acceptance window settings on left ventricular function and perfusion parameters

Objective To evaluate the influence of heartbeat acceptance window settings on left ventricular function and perfusion parameters of the arrhythmia patients during gated myocardial perfusion imaging.Methods Twenty eight fibrillation patients were consecutively recruited to undergo myocardial perfusion SPECT.The Concurrent Imaging software was used to create 3 separate SPECT studies with heartbeat acceptance window of 20%,60% and 100% respectively.The software created the 3 studies separately rather than a rearrangement of an original list-mode acquisition.After reconstruction by Astonish,end-diastole volume(EDV) and end-systolic volume(ESV),left ventricular ejection fraction(LVEF),sum stress score(SSS),and sum rest score(SRS) were calculated with Quantitative Gated SPECT(QGS).Analyses of variance were performed using SPSS to compare the differences in EDV,ESV,EF,SSS,and SRS among the three studies.Results 85.7% of the 28 patients had abnormal perfusing.No statistical differences were found in EDV,ESV,EF,SSS,and SRS among the 3 studies.But the collection time was 40.5 min,25.6 min and 15.0 min for heartbeat acceptance window of 20%,60% and 100% respectively.Conclusion Heartbeat acceptance window setting does not have a significant effect on EDV,ESV,EF,SSS,and SRS values.The wider the window is set,the shorter the collection time is.