Dissertation
Dissertation > Medicine, health > Of Medical > Radiation Medicine > Application of radioisotopes in medicine

Clinical Study of Assessment of Regional Wall Motion by Quantitative Gated Myocardial Perfusion SPECT

Author WuZuoQuan
Tutor XuHao
School Jinan University
Course Nuclear Medicine
Keywords left ventricular regional wall motion gated myocardial perfusion single photon emission computed tomography two-dimensional echocardiography
CLC R817
Type Master's thesis
Year 2002
Downloads 26
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Background: Gated myocardial perfusion SPECT shows regularities and varies of myocardial wall motion between myocardial systolic and diastolic by three-dimensional cine, furthermore, left ventricular regional wall motion was analyzed. The gated myocardial perfusion SPECT allows the simultaneous assessment of myocardial perfusion, left ventricular function and regional wall motion.Objective: To evaluate the feasibility of assessment of left ventricular regional wall motion from gated myocardial perfiision SPECT with 99mTc-MBI (n=158), 201T1 (n=113)and 99mTc-P53 (n=30) in comparison with two-dimensional echocardiography.Methods: Gated myocardial perfusion SPECT with 99mTc-MIBI (n=158), 201T1 (n=113)and 99mTc- Tetrofosmin (P53) (n=30) was performed on 301 cases with different left ventricular function. The left ventricular regional wall motions were evaluated without operator interaction using a automatic gatedmyocardial perfusion SPECT processing software (QGSPECT). After Gated myocardial perfusion SPECT with 99mTc-MIBI, 201T1 and 99mTc-P53, and two-dimensional echocardiography were performed within 7 days, we compared agreement of two consequences using statistical analysis (Kappa value).Results: 1. Left ventricular regional wall motion by gated myocardial perfusion SPECT imaging with 99mTc-MIBI, 201T1 and 99mTc-P53 was successfully analyzed in 301/301(100%) cases (including large myocardial perfusion defect). It allows the simultaneous assessment by three-dimensional cine (endocardia1 surface, epicardiol surface, ED and ES outline) and tomography (horizontal short axis, vertical long axis and horizontal long axis) by showing dynamic regional wall motion.2. Agreement analysis of regional wall motion in overall left ventricular: There was substantial agreement between gated 99mTc-MIBI SPECT and echocardiography for wall motion (Kappa=0.63, P<0.01), There was moderate agreement between quantitative gated 201T1 or 99mTc-P53 SPECT and echocardiography for wall motion (Kappa=0.52, PO.01 and Kappa=0.54, PO.01, respectively.)3. Agreement analysis of regional wall motion in left ventricular regions: There was substantial agreement between 99mTc-MIBI QGSPECT and echocardiography for regional wall motion in left ventricle anterior, anterolateral, inferolateral and inferior (Kappa=0.65-0.74, PO.01) , while moderate agreement in anteroseptal, inferoseptal and posterior (Kappa=0.46-0.51, P<0.01) , and fair agreement in apical (Kappa=0.31, PO.01) . (2)There was substantial agreement between Tl QGSPECT and echocardiography for regional wall motion in left ventricular anterior, inferiorand posterior (Kappa=0.65-0.72, P<0.01) , while moderate agreement in apical ( Kappa=0.42, P<0.01 ) , and fair agreement in anterolateral, inferolateral, anteroseptal, inferoseptal (Kappa=0.27-0.39, P<0.01) . (3) There was excellent agreement between gated 99mTc-P53 SPECT and echocardiography for wall motion in left ventricular anterolateral, inferolateral and inferior (Kappa=0.89, P<0.01), while substantial agreement in anteroseptal (Kappa=0.63, P<0.01) , moderate agreement in anterior, inferoseptal and posterior (Kappa=0.49-0.58, P<0.01) , and fair agreement in apical (Kappa=0.30, P<0.01) .Conclusions: Quantitative gated 99mTc-MEBI, 201T1 and 99mTc-P53 myocardial perfusion SPECT is a reliable tool for the assessment of left ventricular regional wall motion. Quantitative gated myocardial perfusion SPECT offers feasible evidence and actual important significance for evaluating clinical value of left ventricular regional wall motion.

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