ABSTRACT
Objective To explore the optimal and rapid imaging acquisition time and clinical ap-plicability when using high-and low-dose one day rest/stress myocardial perfusion imaging ( MPI) with cad-mium-zinc-telluride heart dedicated SPECT ( CZT-SPECT) . Methods The MPI data with high-dose rest/stress protocol in 51 patients (22 males, 29 females, age:(55.4±8.5) years) between November 2017 and December 2017 and those with low-dose protocol in 50 patients (27 males, 23 females, age:(59.1±12.8) years) between July 2018 and October 2018 were retrospectively analyzed. The MPI was performed with CZT-SPECT. Each patient received 296-370 MBq rest dose of 99Tcm-methoxyisobutylisonitrile (MIBI) for high-dose protocol, 111-222 MBq rest dose of 99 Tcm-MIBI for low-dose protocol. Stress dose was 3 times of the corresponding rest dose. Rest and stress scans were acquired 6 min and 4 min for high-dose protocol, while 8 min and 6 min for low-dose protocol in total. All rest or stress imaging data were reconstructed from list-mode raw data to obtain scan durations of 1 min, 2 min, etc, up to the maximum of acquisition time. Image quality at different acquisition times were evaluated, and myocardial perfusion and function parame-ters were compared. Paired t test, Wilcoxon signed rank test, Pearson correlation and Bland-Altman analyses were used for data analysis. Results The image quality was rated as excellent/good in all patients ( 100％, 51/51) when acquisition time≥3 min and ≥2 min respectively for rest and stress imaging with high-dose protocol, the similar results was obtained ( 100％, 50/50) when acquisition time≥4 min and≥3 min re-spectively for rest and stress imaging with low-dose protocol. The quantitative perfusion parameters(summed rest scores, summed stress scores, total perfusion deficit) and left ventricle ejection fraction ( LVEF) at shor-ter acquisition times (3 min/2 min, 4 min/3 min) were not significantly different from the results at the lon-ger acquisition times (6 min/4 min, 8 min/6 min;t values:from -1.196 to 1.597, z values:from -1.963 to 1. 945, all P>0. 05) . Those parameters at shorter and longer acquisition times showed strong correlations ( all r>0.700, all P<0.001) , and Bland-Altman analysis revealed good agreement between them. Conclusion The opti-mal acquisition time is 3 min/2 min for high-dose one-day rest/stress CZT-SPECT MPI, and 4 min/3 min for low-dose protocol, which can significantly shorten the MPI acquisition time, then reliable perfusion parameters and LVEF can be obtained under the premise of ensuring image quality, making it the better clinical applicability.
ABSTRACT
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.
ABSTRACT
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.