Normal Gated Miyokardiyal Perfüzyon Spect’ E Sahip Kadın Hastalarda Sol Ventrikül Ejeksiyon Fraksiyonu Ve Volüm Değerleri: 4d-Mspect Ve Siemens ICON®-QGS İle Karşılaştırma

ÖzetKoroner arter hastalığı (KAH) teşhisinde gated miyokard perfüzyon SPECT (g-MPS) sık kullanılan bir yöntemidir. Kardiak performansın değerlendirmesinde sol ventrikül ejeksiyon fraksiyon (SVEF), sistol ve diastol sonu volüm en önemli parametrelerdir. Amacımız sol ventrikül ejeksiyon fraksiyonu ve volüm değerlerini normal myokardial perfüzyon ve fonksiyona sahip kadın hastalarda iki g-MPS bilgisayar yazılım programı (4D-MSPECT ve SIEMENS ICON® QGS) ile karşılaştırarak normal sınırlarını belirlemektir.Hastalar ve MethodÇalışmaya KAH şüphesi nedeniyle Ekim 2004-Şubat 2007 tarihleri arasında g-MPS uygulanmış ve sonuçları normal raporlanmış 109 kadın (54 ± 10 yıl) hasta alındı. Tc-99m MIBI kullanılarak tek gün rest-stres g-MPS protokolü uygulandı. Modifiye Bruce protokolü ile hastalara treadmillde veya dobutamin ile efor testi yapıldı. Atenüasyon düzeltmesi yapılmadan "butterworth filtresi" aracılığıyla, rekonstrüksiyon yapıldı. 4DM ve QGS algoritmleri yardımıyla sol ventrikül % EF, end diastolik volüm (EDV;ml), end sistolik volüm (ESV;ml) değerleri hesaplandı. Bulgular4DM ve QGS algoritmaları arasında ortalama rest ve stres EF değerlerinde tüm hastalarda anlamlı düzeyde (∆REF % [4DM-QGS])= 9.5; ∆SEF [4DM-QGS]=8.9; p<0.05) fark bulundu. Sonuçlar arasında geniş Blandt Alman limitleri (BAL) (BAL:[4DM-REF]-[QGS-REF]=26.4-(-7.8), R=0,61 P<0,05; 4DM-SEF-QGS-SEF:27.7-(-10.1), R=0,54; P=0,000) saptandı. Volüm ölçümlerinde güçlü korelasyon katsayı değerleri (r=0.81-0.93) yanında anlamlı farklılıklar (p<0.05) saptandı. Sonuçİki g-MPS yazılım programı arasında, SVEF ve hacim ölçümünde, takipte birbirinin yerine kulllanımı sınırlandıran ortalamalar arası anlamlı derecede farklar saptanmıştır (p<0.05). Takiplerin, başlangıçta kullanılan yazılım programı ile yapılması daha uygundur.

Anahtar Kelimeler:

Gated miyokardiyal perfüzyon SPECT, Sol ventrikül ejeksiyon fraksiyonu, Sol ventriküler sistol sonu ve diastol sonu volüm, 4DM

Left ventricular ejection fraction, end-systolic and end-diastolic volume values in female with normal gated myocardial perfusion spect: the comparison with 4dm-spect and Siemens Icon®-Qgs

AbstractGated myocardial perfusion SPECT (g-MPS) is an important method in the diagnosis of coronary artery disease (CAD). Left ventricular ejection fraction (LVEF), end-systolic volume (ESV) and end-diastolic volume (EDV) are required parameters for evaluation of cardiac performance. Our aim is to compare LVEF and volume values and to determine normal limits in patients with normal myocardial perfusion using two (4D-MSPECT ve SIEMENS ICON® QGS)computer software programs. Patients and MethodsOne hundred nine females were included study with the suspicion of CAD but their g-MPS was reported as normal between October 2004 and February 2007. Single day rest-stress g-MPS protocol was applied. Modified Bruce protocol was done for effort test with tredmill performance or dobutamine injection for pharmacological effort. Reconstruction was performed via Butterworth filtration without attenuation correction. LVEF, ESV and EDV were calculated. ResultsThe mean rest (REF) and stress (SEF) ejection fraction values between 4DM and QGS algorithms had significant differeneces statistically (∆REF[4DM-QGS])=9.5;∆SEF[4DM-QGS]=8.9; p<0.05). Wide Blandt Alman limits (BAL) were detected among the results (BAL:[4DM-REF]-[QGS-REF]=26.4-(-7.8), R=0,61 P<0,05; 4DM-SEF-QGS-SEF:27.7-(-10.1), R=0,54; P=0,000). Significant differences (p<0.05) were found beside the strong correlation coefficient values (r=0.81-0.93) in the volumes. ConclusionThere were significant differences in the averages between the two g-MPS software program in LEVF and volume values so they should not be used in place of each other at the follow-up of patients.

Keywords:

Gated myocardial perfusion SPECT Left ventricule ejection fraction, end systolic volume, end diastolic volume, 4DM,

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