Factors affecting accuracy of ventricular volume and ejection fraction measured by gated Tl-201 myocardial perfusion single photon emission computed tomography

被引:7
作者
Pai, Moonsun
Yang, You-Jung
Im, Ki Chun
Hong, Il Ki
Yun, Sung Cheol
Kang, Duk-Hyun
Song, Jae-Kwan
Moon, Dae Hyuk
机构
[1] Asan Med Ctr, Dept Nucl Med, Seoul 138736, South Korea
[2] Univ Ulsan, Coll Med, Dept Nucl Med, Seoul, South Korea
[3] Ewha Womans Univ, Div Nucl Med, Dept Radiol, Mokdong Hosp, Seoul, South Korea
[4] Asan Med Ctr, Div Epidemiol & Biostat, Seoul, South Korea
[5] Univ Ulsan, Coll Med, Div Cardiol, Asan Med Ctr, Seoul, South Korea
关键词
left ventricular function; left ventricular ejection fraction; single photon emission-computed tomography; thallium-201;
D O I
10.1007/s10554-006-9098-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The electrocardiogram-gated single photon emission computed tomography (SPECT) measurement of left ventricular end-diastolic volume, end-systolic volume and ejection fraction may contain substantial errors. We evaluated whether patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. A total of 518 patients without perfusion defects on Tl-201 SPECT or coronary artery disease were studied. Left ventricular volume and ejection fraction were measured from echocardiography and adenosine stress/redistribution gated Tl-201 SPECT using commercially available software packages (QGS and 4D-MSPECT). We identified factors affecting the accuracy of gated SPECT via multiple linear regression analysis of the differences between echocardiography and gated SPECT. Gated SPECT analyzed with QGS underestimated end-diastolic and end-systolic volume, and overestimated ejection fraction, but 4D-MSPECT overestimated all those values (P < 0.001). Independent variables associated with increasing the difference in end-diastolic volume between echocardiography and gated SPECT were decreasing left ventricular end-diastolic wall thickness, decreasing body surface area, female sex and increasing end-diastolic volume (P < 0.001). Those for end-systolic volume were decreasing left ventricular end-systolic wall thickness, female sex, and decreasing end-systolic volume (P < 0.001). Increasing end-systolic wall thickness, male sex and decreasing age were independent determinants associated with an increased difference in ejection fraction (P < 0.001). Adenosine stress SPECT showed significantly higher end-diastolic and end-systolic volume values and a lower ejection fraction than did redistribution SPECT (P < 0.001). Patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. Modification of gated SPECT measurements by taking account of these factors would lead to reduce systemic errors.
引用
收藏
页码:671 / 681
页数:11
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