| ǥ :
|
ȣ - 490636 41 |
| Influences of Perfusion Defect on the Measurement of Left Ventricular Ejection Fraction and Volumes in Gated Myocardial Perfusion SPECT : Comparison with Two-dimensional Echocardiographic Study |
| Department of Internal Medicine, Nuclear Medicine*,Kyungpook National University, Taegu, Korea |
| Janghoon Lee, Shung Chull Chae, Byeong-Cheol Ahn*, Jaetae Lee*, Hyung Seop Kim, Hyunjae Kang, Yonghwi Park, Juyup Han, Hyunsang Lee, Hyeonmin Ryu, Yongkeun Cho, Dongheon Yang, Hun Sik Park, Jae-Eun Jun, Wee-Hyun Park |
Background: Left ventricular ejection fraction(LVEF) and volumes(LVV) are important variables for the treatment and follow-up study in patient with heart disease. Quantitative gated myocardial perfusion SPECT(QGS) permits simultaneous assessment of left ventricular perfusion, LVEF and LVV. But the presence of perfusion defect may influence the LVEF and LVV measured by QGS. Methods: Sixty seven subjects(M/F = 47/20; mean age : 60.2±12.4yrs) underwent both stress QGS with Tc-99m MIBI and 2-D echocardiography(Echo) less than 7 days apart of each other. The LVEF and LVV were measured by Echo using modified Simpson’s method and Tc-99m gated myocardial perfusion SPECT using automatic software, AutoQUANT. Rest images in QGS were used for the comparison with Echo. Results: In all subjects(n=67), the correlations between QGS and Echo with respect to LVEF, LVEDV and LVESV were good(r=0.781, r=0.754, r=0.906, p<0.0001). But the LVEF was higher with Echo by 4.3±7.6%(55.3±12.0% vs 59.7±10.4%, p<0.001), and the LVEDV and LVESV were higher with QGS by 8.3±29.2ml(98.4±43.7ml vs 90.1±27.9ml, p<0.001) and 9.4±20.2ml(47.2±39.3ml vs 37.7±24.1ml, p<0.029). In the patients without perfusion defect(n=34), the correlations between QGS and Echo with respect to LVEF, LVEDV and LVESV were good(r=0.689, r=0.593, r=0.586, p<0.0001) without difference between the two values. In patients with perfusion defect(n=33), the LVEF between QGS and Echo was well correlated(r=0.777, p<0.0001), but the LVEF was higher with Echo by 7.1±8.7%(49.3±13.3% vs 56.4±12.7%, p<0.001). The LVEDV and LVESV by QGS and Echo were also well correlated(r=0.804, r=0.929, p<0.0001), but the LVEDV and LVESV were higher with QGS by 17.9±34ml(113.0±54.6ml vs 95.0±33.6ml, p=0.007) and 16.9±25ml(61.2±51.9ml vs 44.2±32.1ml, p=0.001). Bland-Altman analysis showed that the agreement of LVEF and LVV between QGS and Echo in the patients without perfusion defect was better than those in patients with perfusion defect(LVEF: 10.4% vs 17.4%, LVEDV: 40.4ml vs 68.1ml, LVESV: 21.6ml vs 50.0ml). Conclusions: The perfusion defect in QGS might affect the measurement of LVEF and LVV. Therefore, the values of QGS and Echo are not interchangeable for their measurement.
|
|
|
|
|
