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Gated myocardial SPECT imaging of coronary heart disease low probability of cardiac function parameters influencing factors research

Author: LiJiaJun
Tutor: HeZuoXiang;TianYueQin;YangMinFu
School: Beijing Union Medical College
Course: Medical Imaging and Nuclear Medicine
Keywords: Ejection fraction Diastolic volume End-systolic volume Gender Age Gated myocardial SPECT imaging Filtered back projection Ordered subset expectation maximization method Dual radionuclide imaging Acute myocardial infarction Viable myocardium Cardiac function Prognosis
CLC: R541.4
Type: Master's thesis
Year: 2011
Downloads: 24
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Abstract


Objective of the physiological factors of coronary heart disease in the first part of the gated myocardial SPECT imaging low probability parameters of cardiac function in patients for coronary heart disease low degree of possible patients gated myocardial perfusion imaging cardiac function parameters reference range, and analyze physiological factors such as gender, age and weight affect cardiac function parameter values. Materials and methods coronary heart disease low degree of likelihood of patients 175 patients (male 89, female 86 cases) underwent 99Tcm-MIBI stress gated myocardial SPECT imaging the QGS software measurement the EDV, ESV.EF value using the normal distribution method and the percentile method to determine the reference range of parameter values, and analysis of the impact of gender, age and weight of the parameter values. Male and EF values ??lower limit of 52%, EDV, ESV, a maximum of 106 ml, 45 ml; female EF value of the lower limit of 58%, the EDV.ESV a maximum of 73 ml, 27 ml; the male significantly higher than women [EDV EDV.ESV: ( 75.8 ± 18.7) ml (53.3 ± 11.7) ml, t = 9.35, P lt; 0.0001; ESV: (27.1 ± 10.9) ml (14.3 ± 7.9) ml, t = 8.59, P lt; 0.0001]; EF values EF, ESV value predictors, in addition to gender, age, body weight, but also ventricular volume predictors; gender EDV, ESV and EF with gender, age, weight trend may not be the same. Conclusion gated myocardial SPECT imaging measurement different gender, age differences in heart function parameters, the men and women of different parameter values, increases with age and changes in trends. The second part of the gated myocardial SPECT imaging of three quantitative analysis software measuring coronary heart disease three quantitative analysis software measured low degree of coronary heart disease may range of reference values ??of the parameters of the cardiac function in patients with low probability of cardiac function parameters reference range Objective To determine and compare the difference. Materials and methods of coronary heart disease is low probability of 175 cases (male 89, female 86 cases) underwent 99Tcm-MIBI gated myocardial SPECT imaging load with QGS.ECToolbox, 4D-MSPECT software were measured the EDV, ESV.EF value normal distribution method or the percentile method to determine the reference range of parameter values, and compare three software measurement results. Good correlation of the results of three software measured value, measured LVEF of r values ??are in the 0.80-0.85, P value lt; 0.001; EDV.ESV r values ??are in the 0.89-0.96, P value lt; 0.001; three kinds Software Determination of EDV and EF values ??were significantly different (P lt; 0.005), while the ESV is no significant difference; QGS measured value [LVEF: (71 ± 10)% lower than the 4D EDV: (61 ± 18) m1] (81 ± 24) ml]; ESV (QGS) [(19 ± 11) m1] ECToolbox [(18 ± 12) ml] the measured values ??with the 4D-MSPECT [(18 ± 11) ml] was no statistical difference significance (P = 0.602); The software of ECToolbox measuring male EF lower limit of 63%, EDV.ESV up 15.2 ml.53 ml men measured by 4D.MSPECT EF lower limit of the 58%, EDV, ESV, up 13.5 ml.55 ml; female heart function range of parameter values ??(QGS) software measurement EF value of the lower limit of the 58% ceiling EDV.ESV 77 ml.30 ml; the ECToolbox software measurement EF lower limit of 66%, EDV.ESV a maximum of 105 ml.31ml the 4D-MSPECT measurement value EF lower limit of 65%, maximum 88 ml.29 ml EDV.ESV. the conclusion three software measured EDV.ESV.EF value good, but the differences between EDV and EF values, measured values ??of three software reference range initially established. The third part of the FBP and OSEM reconstructed images measuring cardiac function parameters comparison purposes compare resting gated myocardial perfusion imaging FBP and OSEM reconstruction image QGS.4D-MSPECT. ECToolbox heart function parameters measured. Materials and methods clinically suspected or confirmed 144 cases of patients with coronary artery disease underwent 99Tcm-MIBI resting gated myocardial SPECT imaging, all patients with FBP and OSEM reconstruction image, with the QGS.4D-MSPECT. ECToolbox software to calculate cardiac function parameters : LVEF.EDV.ESV: to test two reconstruction methods Bland.Altman law consistency, paired t-test method to test heart function parameters difference correlation analysis using linear regression analysis. Results FBP and OSEM reconstructed measurements of cardiac function parameters consistency and good correlation (correlation coefficient r gt; 0.93, P lt; 0.001); (QGS) software FBP reconstructed measured EDV EDV lower than OSEM reconstructed measured other two software FBP method than OSEM method (QGS): (82.2 ± 39.1) ml (83.5 ± 40.8) ml, t = 2.53, P lt; 0.05; the 4D-MSPECT: (93.5 ± 46.9) ml and ( 88.8 ± 45.2) ml, t = 5.95, P lt; 0.001; ECToolbox: (106.4 ± 51.1) ml and (100.8 disabilities 49.0) ml, t = 3.99, P lt; 0.001]; For ESV, 4D-MSPECT software measurement EF value was significantly lower than the the EF measured value using OSEM [(62.1 ± 16.9)% and (63.1 ± 16.1)%, t = -3.14, P lt; 0.003]; the EF value ECToolbox software FBP method measured significantly higher at use the EF value OSEM measured by [(74.1 ± 18.8)% and (71.3 Guests 17.1)%, t = 5.28, P lt; 0.001]. Cardiac function parameters measured by the conclusion of two reconstruction methods and consistency is very good, but some parameter value size difference. Part IV patients with acute myocardial infarction 18F-FDG/99Tcm-MIBI myocardial SPECT imaging in detection of myocardial viability Objective To investigate 18F-FDG/99Tcm-MIBI dual radionuclide myocardial perfusion imaging through detection of acute myocardial infarction in patients with viable myocardium, improve heart function and The prognosis of the clinical value of the judgment. Materials and Methods 98 patients diagnosed with acute myocardial infarction patients underwent 18F-FDG/99Tcm-MIBI dual radionuclide myocardial perfusion imaging in detecting viable myocardium, treatment before and after echocardiography observed LVEF changes, all patients were followed up, and Statistics The incidence of cardiac events. Results myocardial viability group of 37 patients, of which 27 patients underwent coronary revascularization, 10 patients who received drug therapy; myocardial no survival group, 61 patients to accept the revascularization treatment and medication were 35 cases and 26 cases. Myocardial viability group or myocardial survival group, treatment and drug therapy compared with revascularization, heart function improved significantly between the two groups (LVEF increased the proportion of patients with ≥ 10%) were not significant differences (myocardial viability group X2 = 0.509, P gt; 0.05; myocardial no survival group X2 = 0.035, P gt; 0.05) average follow-up time (23 ± 11) months, myocardial viability group received drug treatment in patients with cardiac event rate was significantly higher than accepted revascularization-treated patients (50.0% and 14.8%, X2 = 4.91, P lt; 0.05); incidence of cardiac events in myocardial no survival group, drug treatment patients also significantly higher than revascularization (30.7% than 5.7%, χ2 = 6.83, P lt; 0.05). Conclusion 18F-FDG/99Tcm-MIBI dual radionuclide myocardial perfusion imaging, myocardial viability in order to determine the clinical value of the improvement of cardiac function and prognosis also can not be sure, but also need large-scale prospective study further confirmed by the detection of acute myocardial infarction.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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