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Influence of the arm position in myocardial perfusion imaging acquisition / Influência da posição dos braços na aquisição da cintilografia do miocárdio
Izaki, Marisa; Soares Junior, José; Giorgi, Maria Clementina Pinto; Meneghetti, Jose Claudio.
  • Izaki, Marisa; USP. FM. HC. Department of Nuclear Medicine and Molecular Imaging Heart Institute. São Paulo. BR
  • Soares Junior, José; USP. FM. HC. Department of Nuclear Medicine and Molecular Imaging Heart Institute. São Paulo. BR
  • Giorgi, Maria Clementina Pinto; USP. FM. HC. Department of Nuclear Medicine and Molecular Imaging Heart Institute. São Paulo. BR
  • Meneghetti, Jose Claudio; USP. FM. HC. Department of Nuclear Medicine and Molecular Imaging Heart Institute. São Paulo. BR
Rev. Assoc. Med. Bras. (1992) ; 60(4): 311-317, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-720985
ABSTRACT

Objective:

despite the technologic advances in myocardial perfusion imaging, we keep using an uncomfortable and sometimes impracticable patient position - supine with arms raised above the head (U). The purpose of this study was to investigate whether perfusion and functional cardiac gated SPECT scan results of acquisition U are equivalent to another position modality supine with arms down at the sides of the trunk (D). Methods and

Results:

we performed U acquisition and in sequence D acquisition in 120 patients (pts) using a one-day MPI (rest-gated/stress), with 99mTc-sestamibi (370 MBq and 1110 MBq). Images were processed by the iterative reconstruction method (OSEM). Rest (R) and stress (S) studies were scored using 17-segments model. Functional parameters (left ventricular ejection fraction, and volumes) were automatically obtained by the quantitative gated SPECT (QGS) program. According to the degree of stress defects observed in U study, the patients were categorized in two subgroups normal (SSS ≤ 3 or < 5%) and abnormal (SSS>3 or ≥ 5%). Shoulder/back pain occurred in 23.3% of U patients and in 5% of D. No significant differences between U and D were found for SSS (p = 0.82) and SRS (p = 0.74) in normal group. In abnormal group, good correlation was found between U and D modes for SSS (Rho = 0.95, p = 0.0001) and SRS (Rho = 0.96 p = 0.0001), but the mean SSS (12.53 ± 7.54) and SRS (10.60 ± 7.08) values of D were significantly lower (p < 0.05) than SSS (13.43 ± 6.81) and SRS (11.33 ± 6.97) of U mode. Function measurements presented good correlations, except for end-diastolic volume (p = 0.0001).

Conclusion:

although D mode appears to be more comfortable and presented a good correlation with U values of SSS and SRS, in abnormal pts, the extent and severity of defects can be underestimated. Considering clinical implications of an accurate perfusion measurement, the acquisition with the ...
RESUMO

Objetivo:

no estudo de perfusão miocárdica, apesar dos avanços tecnológicos, continuamos utilizando o desconfortável e às vezes impraticável posicionamento em decúbito dorsal com braços acima da cabeça (U). O objetivo do estudo foi investigar se os resultados da perfusão e da função cardíacas obtidos com a aquisição U são equivalentes ao de outra modalidade de posição com braços para baixo nas laterais do tronco (D). Métodos e

resultados:

adquirida a aquisição U, na sequência foi realizada a aquisição D em 120 pacientes (pts) em um único dia (repouso e estresse sincronizado ao ECG), com 99mTc-sestamibi (370 MBq e 1110 MBq). As imagens foram processadas usando reconstrução iterativa (OSEM). Cada estudo foi quantificado usando o modelo de 17-segmentos ao repouso (R) e ao estresse (S). Os parâmetros funcionais (fração de ejeção do ventrículo esquerdo e volumes) foram obtidas automaticamente pelo programa gated SPECT quantitativa (QGS). De acordo com a dimensão da alteração perfusional no estresse na aquisição U, os pacientes foram classificados em dois subgrupos 80 pts normais (SSS ≤ 3 ou < 5%) e 40 pts anormais (SSS > 3 ou ≥ 5%). Dor no ombro e/ou nas costas ocorreu em 23,3% dos pacientes de U e em 5% de D. Não houve diferenças significativas entre U e D quanto ao SSS (p = 0,82) e SRS (p = 0,74) no grupo normal. No grupo anormal, boa correlação foi encontrada entre U e D para SSS (Rho = 0,95, p = 0,0001) e SRS (Rho = 0,96 p = 0,0001), entretanto a média dos valores de SSS (12,53 ± 7,54) e SRS (10,60 ± 7,08 ) de D foram significativamente menores (p < 0,05) que o SSS (13,43 ± 6,81) e SRS (11,33 ± 6,97) de U. As medidas de função apresentaram boas correlações, ...
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Arm / Tomography, Emission-Computed, Single-Photon / Supine Position / Myocardial Perfusion Imaging / Patient Positioning Type of study: Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: USP/BR

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Full text: Available Index: LILACS (Americas) Main subject: Arm / Tomography, Emission-Computed, Single-Photon / Supine Position / Myocardial Perfusion Imaging / Patient Positioning Type of study: Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: USP/BR