Ayşe Esra ARSLAN, İrfan PEKSOY, Rıza ŞEFİZADE

MPS’de SPECT/BT ve EKG-Gated ile Atenüasyon Düzeltmeli̇ Görüntüleri̇n Eklenmesi̇ Hangi̇ Hasta Grubu İçi̇n Faydalıdır?

Amaç: Miyokard perfüzyon sintigrafisinde (MPS), meme dokusu atenüasyonu ve diyafragma atenüasyonu gibi yanlış pozitifliğe neden olan çok sayıda neden vardır. Çalışmamızda MPS’de rest görüntülemeye çağırmada, Tek foton komputerize tomografi/Bilgisayarlı tomografi (SPECT/BT) ve elektrokardiyografi (EKG) gated Tek foton komputerize tomografi (SPECT)’yi etkileyen faktörlerin katkısını araştırmak istedik. Gereç ve Yöntemler: Şubat 2012 ve Mayıs 2013 tarihleri arasında MPS SPECT/BT yapılan ve normal çalışma olarak yorumlanan 258 hasta çalışmaya dahil edildi. Stres atenüasyon düzeltmeli (AD), atenüasyon düzeltmeli olmayan (NAD) ve EKG-gated SPECT görüntüleri ayrı ayrı analiz edildi ve rest MPS gerekip gerekmediğine karar verildi. Ayrıca rest gerekliliği ile vücut kitle indeksi (VKİ), yaş ve cinsiyet arasındaki ilişki değerlendirildi. Bulgular: NAD MPS görüntüleri tek başına değerlendirildiğinde, 258 hastanın 127’sinde (%49.2) rest MPS ihtiyacı olduğu saptandı. MPS görüntüleri SPECT/BT ile yapılan AD ile yorumladığımızda bu oran %11.2’ye düştü. SPECT/BT’ye EKG-gated SPECT görüntüleri eklendiğinde bu oranın %6.6’ya düşmekte olduğu ve bu görüntülerin VKİ<35kg/m² olan hasta grubunda en büyük katkıyı sağladığı görüldü. Sonuç: SPECT/BT ile yapılan AD ve EKG-Gated ile MPS’nin özellikle VKİ<35 kg/m² olan hastalar için faydalı olacağını düşünüyoruz.

Anahtar Kelimeler:

Atenüasyon düzeltme, Miyokard perfüzyon sintigrafisi, SPECT/BT

Adding Attenuation Corrected Images with SPECT/CT and ECG-Gated in MPI is Usefull for Which Group of Patient?

Aim: There are large number of reasons which causes false positivity in myocardial perfusion imaging (MPI) as breast tissue and diaphragm attenuation. In our study, we want to investigate that the factors which affect MPI rest recall, single photon emission computerized tomography/computerized tomography (SPECT/CT) and electrocardiography ECG-Gated SPECT’s contribution. Material and Methods: Between February 2012 and May 2013, 258 patient included the study who have done MPI SPECT/CT and interpreted as normal study. The attenuation corrected (AC), non-attenuation-corrected (NAC) and ECG-Gated SPECT images were analyzed separately and decided to rest MPI need or not. The relationship between body mass index (BMI), age and gender were evaluated. Results: When the NAC MPI images are evaluated alone, in 127 of 258 patient (49.2%) was found that they need rest MPI. When we interpret AC images with SPECT/CT, this ratio fell down to 11.2%. When ECG-gated SPECT images added to AC with SPECT/ CT, this ratio decreases to 6.6% and these images provides the greatest contribution to the group of patients whose BMI <35kg/m². Conclusion: We think that AC MPI with SPECT/CT and EKG -gated can be done especially for patients with BMI<35 kg/m².

Keywords:

Attenuation correction, myocardial perfusion imaging, SPECT/CT,

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