CAJ | 학술논문

目的探讨门控和定量分析技术在82Rb PET心肌灌注显像中的应用价值.方法对32例临床可疑冠心病患者进行静息/腺苷负荷82Rb PET门控心肌灌注显像.原始数据按常规处理成断层图像,再应用定量分析软件Emory Cardiac Toolbox(ECTb)进行定量分析.由3位有经验的核医学科医师分别对图像质量(优、良、一般、差、无法分析)、左心室射血分数(LVEF)的可信程度(同意、基本同意、不确定、基本不同意、不同意)、左心室功能的其他指标对诊断的价值(很有帮助、有帮助、不确定、基本无帮助、无帮助)进行评价.将观察指标分为肯定组和否定组,分别计算其百分率和90%可信区间.结果 192组分析结果中,图像质量优良者共计160组,占83.3%(160/192),其95%可信区间为78.1%～88.6%;图像质量为一般和差的共计32组,占16.7%(32/192),其95%可信区间为11.4%～21.9%.对LVEF的结果表示同意和基本同意者共计164组,占85.4%(164/192),其95%可信区间为80.4%～90.4%;认为不确定和基本不同意或不同意者共计28组,占14.6%(28/192),其95%可信区间为9.6%～19.6%.应用定量分析软件获得的除LVEF以外左心室功能的其他指标,认为很有帮助和有帮助者共计102组,占53.1%(102/192),其95%可信区间为46.1%～60.2%;不确定和基本无帮助或无帮助者90组,占46.9%(90/192),其95%可信区间为39.8%～53.9%.结论门控和定量分析技术有助于PET图像阅片者作出更正确的诊断.
목적 탐토문공화정량분석기술재82Rb PET심기관주현상중적응용개치.방법 대32례림상가의관심병환자진행정식/선감부하82Rb PET문공심기관주현상.원시수거안상규처리성단층도상,재응용정량분석연건Emory Cardiac Toolbox(ECTb)진행정량분석.유3위유경험적핵의학과의사분별대도상질량(우、량、일반、차、무법분석)、좌심실사혈분수(LVEF)적가신정도(동의、기본동의、불학정、기본불동의、불동의)、좌심실공능적기타지표대진단적개치(흔유방조、유방조、불학정、기본무방조、무방조)진행평개.장관찰지표분위긍정조화부정조,분별계산기백분솔화90%가신구간.결과 192조분석결과중,도상질량우량자공계160조,점83.3%(160/192),기95%가신구간위78.1%～88.6%;도상질량위일반화차적공계32조,점16.7%(32/192),기95%가신구간위11.4%～21.9%.대LVEF적결과표시동의화기본동의자공계164조,점85.4%(164/192),기95%가신구간위80.4%～90.4%;인위불학정화기본불동의혹불동의자공계28조,점14.6%(28/192),기95%가신구간위9.6%～19.6%.응용정량분석연건획득적제LVEF이외좌심실공능적기타지표,인위흔유방조화유방조자공계102조,점53.1%(102/192),기95%가신구간위46.1%～60.2%;불학정화기본무방조혹무방조자90조,점46.9%(90/192),기95%가신구간위39.8%～53.9%.결론 문공화정량분석기술유조우PET도상열편자작출경정학적진단.
Objective Gated myocardial perfusion imaging (MPI) is regularly performed using SPECT. More recently, gated 82Rb MPI has been used to assess left ventricular myocardial perfusion and function with new generation PET scanners. The objective of this study was to evaluate the value of rest and stress gated 82 Rb PET myocardial perfusion imaging and to determine whether the quantitative technique increased the confidence level of the interpreters. Methods Thirty-two patients underwent rest and adenosine stress gated 82Rb PET MPI. Emory Cardiac Toolbox quantitative software was used for processing and interpretation. Left ventricular ejection fraction (LVEF), end-diastolic, end-systolic and transient ischemia dilation ratio were automatically generated. Three interpreters (nuclear medicine doctors) independently reviewed the studies. Visual scoring (1 - 5 scales : excellent, good, unsure, poor, uninterpretable) was used to assess the overall quality of the gated images and the added confidence level of interpretation. Visual assessment of the LVEF was compared to the automatically generated LVEF. Comparison between the visual assessment and software generated was graded on a 1- 5 scales (helpful, probably helpful, unsure, probably not helpful, definitely not helpful). The analysed items were divided into two groups (favorable group and negative group). The percentage and 95% confidence intervals of each group were calculated. Results A total of 192 gated studies were evaluated (64 gated × 3 interpreters). The overall quality of the gated images was good [excellent 40.1% (77/192) , good 43.2% (83/192), unsure 3.1% (6/192), poor 13.6% (26/192), uninterpretable 0]. The 95% confidence intervals of good and excellent quality range from 78.1% to 88.6%. The interpreters agreed with the automated LVEF on 85.4% of the gated images [agree 76.6% (147/192), probably agree 8.8% (17/192), unsure 3.1% (6/192), probably disagree 8. 8% (17/192), disagree 2.6% (5/192)]. And its 95% confidence intervals range from 80.4% to 90. 4%. Moreover, the functional information provided additional confidence for image interpretation [helpful 25.0% (48/192), probably helpful 28. 1% (54/192), unsure 2.6% (5/192), probably not helpful 15.1% (29/192), definitely not helpful 29.2% (59/192)]. The 95% confidence intervals of regarding the functional information as helpful and probably helpful range from 46.1% to 60.2%. Conclusion Rest and stress gated sz Rb PET myocardial perfusion imaging and quantitative software are helpful to the interpreters in their diagnosis of coronary artery disease.