中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
6期
444-447
,共4页
黄克敏%冯彦林%温广华%梁伟棠%余丰文%刘德军
黃剋敏%馮彥林%溫廣華%樑偉棠%餘豐文%劉德軍
황극민%풍언림%온엄화%량위당%여봉문%류덕군
心肌%体层摄影术,发射型计算机,单光子%体位%伪迹%MIBI
心肌%體層攝影術,髮射型計算機,單光子%體位%偽跡%MIBI
심기%체층섭영술,발사형계산궤,단광자%체위%위적%MIBI
Myocardium%Tomography,emission-computed,single-photon%Posture%Artifacts%MIBI
目的 探讨采用右侧卧位并改变采集角度显像对成年女性SPECT MPI中左心室前壁衰减伪影的鉴别价值.方法 回顾性分析行99Tcm-MIBI MPI的成年女性49例[年龄(61.5±8.4)岁,属冠心病低发人群].运动负荷显像时患者左心室前壁均出现不同程度的稀疏或缺损,随机(抽签法)对患者先后行常规仰卧位和改变采集角度的右侧卧位静息显像.重建2种显像体位的心肌断层图像,利用靶心图获得左心室各壁段的放射性计数百分比.采用配对t检验比较2种显像体位间的放射性计数百分比差异.观察不同体位显像时左心室前壁放射性稀疏和填充的图像差异.结果 左心室前壁、下后壁、心尖部及侧壁的放射性计数百分比在右侧卧位显像时明显高于仰卧位显像,分别为(71.30±3.53)％和(66.50±3.85)％,(70.06±4.45)％和(65.44±4.16)％,(77.90±3.00)％和(75.81±4.08)％,(79.30±2.26)％和(72.60±3.87)％(t=6.731、5.286、3.555和10.885,均P＜0.01),间壁的放射性计数百分比明显低于仰卧位显像[(66.60±3.98)％和(70.06±4.51)％,t=-4.625,P＜0.01].左心室前壁中段和前壁心尖部放射性计数百分比在右侧卧位显像时明显高于仰卧位显像[中段:(76.40±3.80)％和(68.60±4.76)％,心尖部:(77.10±3.24)％和(69.00±3.54)％;t=9.916和8.870,均P＜0.01],前壁基底部放射性计数百分比在2种显像体位间的差异无统计学意义[(56.94±6.06)％和(58.50±4.98)％,t=-1.493,P＞0.05].目测49例受检者常规仰卧位显像时,左心室前壁均有不同程度的稀疏或缺损,其中出现前壁中段和前壁心尖部局限性稀疏缺损的受检者分别为46.9％ (23/49)和32.7％ (16/49);采用右侧卧位同时改变采集角度显像时,左心室前壁的稀疏缺损区均有不同程度的填充,其中出现明显填充和完全填充的受检者分别为24.5％(12/49)和65.3％ (32/49).结论 仰卧位显像时成年女性左心室前壁的衰减伪影主要表现为前壁中段或前壁心尖部的局限性稀疏或缺损;采用右侧卧位同时改变采集角度显像能有效减少和鉴别成年女性左心室前壁的衰减伪影.
目的 探討採用右側臥位併改變採集角度顯像對成年女性SPECT MPI中左心室前壁衰減偽影的鑒彆價值.方法 迴顧性分析行99Tcm-MIBI MPI的成年女性49例[年齡(61.5±8.4)歲,屬冠心病低髮人群].運動負荷顯像時患者左心室前壁均齣現不同程度的稀疏或缺損,隨機(抽籤法)對患者先後行常規仰臥位和改變採集角度的右側臥位靜息顯像.重建2種顯像體位的心肌斷層圖像,利用靶心圖穫得左心室各壁段的放射性計數百分比.採用配對t檢驗比較2種顯像體位間的放射性計數百分比差異.觀察不同體位顯像時左心室前壁放射性稀疏和填充的圖像差異.結果 左心室前壁、下後壁、心尖部及側壁的放射性計數百分比在右側臥位顯像時明顯高于仰臥位顯像,分彆為(71.30±3.53)％和(66.50±3.85)％,(70.06±4.45)％和(65.44±4.16)％,(77.90±3.00)％和(75.81±4.08)％,(79.30±2.26)％和(72.60±3.87)％(t=6.731、5.286、3.555和10.885,均P＜0.01),間壁的放射性計數百分比明顯低于仰臥位顯像[(66.60±3.98)％和(70.06±4.51)％,t=-4.625,P＜0.01].左心室前壁中段和前壁心尖部放射性計數百分比在右側臥位顯像時明顯高于仰臥位顯像[中段:(76.40±3.80)％和(68.60±4.76)％,心尖部:(77.10±3.24)％和(69.00±3.54)％;t=9.916和8.870,均P＜0.01],前壁基底部放射性計數百分比在2種顯像體位間的差異無統計學意義[(56.94±6.06)％和(58.50±4.98)％,t=-1.493,P＞0.05].目測49例受檢者常規仰臥位顯像時,左心室前壁均有不同程度的稀疏或缺損,其中齣現前壁中段和前壁心尖部跼限性稀疏缺損的受檢者分彆為46.9％ (23/49)和32.7％ (16/49);採用右側臥位同時改變採集角度顯像時,左心室前壁的稀疏缺損區均有不同程度的填充,其中齣現明顯填充和完全填充的受檢者分彆為24.5％(12/49)和65.3％ (32/49).結論 仰臥位顯像時成年女性左心室前壁的衰減偽影主要錶現為前壁中段或前壁心尖部的跼限性稀疏或缺損;採用右側臥位同時改變採集角度顯像能有效減少和鑒彆成年女性左心室前壁的衰減偽影.
목적 탐토채용우측와위병개변채집각도현상대성년녀성SPECT MPI중좌심실전벽쇠감위영적감별개치.방법 회고성분석행99Tcm-MIBI MPI적성년녀성49례[년령(61.5±8.4)세,속관심병저발인군].운동부하현상시환자좌심실전벽균출현불동정도적희소혹결손,수궤(추첨법)대환자선후행상규앙와위화개변채집각도적우측와위정식현상.중건2충현상체위적심기단층도상,이용파심도획득좌심실각벽단적방사성계수백분비.채용배대t검험비교2충현상체위간적방사성계수백분비차이.관찰불동체위현상시좌심실전벽방사성희소화전충적도상차이.결과 좌심실전벽、하후벽、심첨부급측벽적방사성계수백분비재우측와위현상시명현고우앙와위현상,분별위(71.30±3.53)％화(66.50±3.85)％,(70.06±4.45)％화(65.44±4.16)％,(77.90±3.00)％화(75.81±4.08)％,(79.30±2.26)％화(72.60±3.87)％(t=6.731、5.286、3.555화10.885,균P＜0.01),간벽적방사성계수백분비명현저우앙와위현상[(66.60±3.98)％화(70.06±4.51)％,t=-4.625,P＜0.01].좌심실전벽중단화전벽심첨부방사성계수백분비재우측와위현상시명현고우앙와위현상[중단:(76.40±3.80)％화(68.60±4.76)％,심첨부:(77.10±3.24)％화(69.00±3.54)％;t=9.916화8.870,균P＜0.01],전벽기저부방사성계수백분비재2충현상체위간적차이무통계학의의[(56.94±6.06)％화(58.50±4.98)％,t=-1.493,P＞0.05].목측49례수검자상규앙와위현상시,좌심실전벽균유불동정도적희소혹결손,기중출현전벽중단화전벽심첨부국한성희소결손적수검자분별위46.9％ (23/49)화32.7％ (16/49);채용우측와위동시개변채집각도현상시,좌심실전벽적희소결손구균유불동정도적전충,기중출현명현전충화완전전충적수검자분별위24.5％(12/49)화65.3％ (32/49).결론 앙와위현상시성년녀성좌심실전벽적쇠감위영주요표현위전벽중단혹전벽심첨부적국한성희소혹결손;채용우측와위동시개변채집각도현상능유효감소화감별성년녀성좌심실전벽적쇠감위영.
Objective To explore the value of right lateral decubitus position MPI for differentiating myocardial perfusion defect from cardiac anterior wall attenuation artificial defect,caused by breast of woman.Methods Forty-nine patients(average age (61.5±8.4) years) who had low likelihood of coronary artery disease and had perfusion defect in the anterior wall after exercise stress 99Tcm-MIBI MPI were included.All underwent supine and right lateral decubitus position during resting SPECT images.The myocardial perfusion SPECT images at left ventricle were reconstructed and were measured by Bull's-eye,based on the counts.Results from both supine position imaging and right lateral decubitus position imaging were compared.Paired t test was used to statistically analyse the data by SPSS 13.0.Results Compared with supine position,the counts of the anterior,inferior,apex and lateral wall in right lateral decubitus position were significantly higher:(71.30±3.53) ％ vs (66.50±3.85) ％,(70.06±4.45) ％ vs (65.44±4.16) ％,(77.90±3.00)％ vs (75.81±4.08)％,(79.30±2.26)％ vs (72.60±3.87)％ (t=6.731,5.286,3.555,10.885,all P＜0.01).The counts of septal wall were significantly lower ((66.60±3.98)％ vs (70.06±4.51)％,t=-4.625,P＜0.01) in right lateral decubitus position than that in supine position.Among the different regions of anterior wall,the counts of the anterior-middle ((76.40 ± 3.80) ％ vs (68.60 ± 4.76) ％) and anterior-apex region ((77.10±3.24) ％ vs (69.00±3.54) ％) were significantly higher (t =9.916,8.870,both P＜0.01) in right lateral decubitus position than those in supine position,but there was insignificance ((56.94±6.06)％ vs (58.50±4.98) ％,t =-1.493,P＞0.05) at anterior-basal region.The artificial defect of different degrees in anterior wall was observed in all patients in supine position,23 cases (46.9％,23/49) showed artificial defect in the anterior-middle region and 16 cases (32.7％,16/49) in the anterior-apex region.All artificial defect showed radioactive filling in right lateral position imaging,12 cases(24.5％,12/49) filled markedly and 32 cases(65.3％,32/49) filled completely.Conclusions The artificial defects caused by breast of woman mainly present in anterior-middle region and in anterior-apex region of the anterior wall in supine position imaging.The right lateral decubitus position imaging can markedly improve these artificial defects.
