【摘要】 目的探讨适当延长再分布显像数据采集时间对201Tl心肌显像图像质量和诊断结论的影响。方法对31例患者于腺苷负荷试验和静脉注射201Tl后6 min内开始采集腺苷负荷显像(ASI)数据,(200.61±13.64)min后采集常规再分布显像(TRI)数据,然后每帧增加12 s,采集加时再分布显像(PTRI)数据。用完全一致的参数重建图像后,比较分析ASI、TRI和PTRI的总计数(TC)差异。3位医师通过双盲法分别对图像质量进行目测评价,再比较分析ASI-TRI和ASI-PTRI方法所得心肌图像的诊断结论。结果 31例患者中,2例因PTRI的TC大于ASI的TC而未纳入本研究数据分析。29例有效患者ASI与TRI的TC的平均差异为(21.58±0.02)%,差异有统计学意义(t=48.799,P<0.05);而ASI与PTRI的TC的平均差异为(2.95±0.03)%,差异无统计学意义(t=2.100,P=0.151);PTRI的图像质量有明显改善;共有11例患者(11/29,37.93%)可能根据PTRI改变诊断结论,其中2位医师一致认可者为6例(6/29,20.69%),3位医师一致认可者为3例(3/29,10.34%),另外2例(2/29,6.90%)分别有1位医师认可。可疑诊断结论从ASI-TRI的24人次下降到ASI-PTRI的13人次(χ2=4.978,P=0.004)。结论 ASI-PTRI201Tl心肌显像法可明显提高图像质量,有可能进一步提高诊断的客观性。更多还原

【Abstract】 Objective To explore the influences of the image quality and diagnostic objectivity of myocardial imaging(MI) with 201Tl by increasing the redistribution imaging data acquisition time.Methods For 31 patients with suspected heart failure,emission data of adenosine stress imaging(ASI) were acquired within 6 min after adenosine test and(200.61±13.64)min later for traditional redistribution imaging(TRI) using the same imaging parameters as the ASI.Then 12 s was increased immediately per projection for the plus time redistribution imaging(PTRI) data acquisition.The same parameters were used for the image reconstruction of the ASI,TRI and PTRI imaging.Images were displayed as pair of ASI-TRI and ASI-PTRI,respectively.The total counts(TC) of the ASI,TRI and PTRI,and the differences of the ASI-TRI and ASI-PTRI were compared,respectively.The image quality and diagnostic objectivity were assessed by 3 veteran nuclear medicine doctors with double-blind mothod.Results Two of the 31 patients were excluded because of TC of PTRI was more than that of the ASI.For the effective 29 patients,the mean difference of TC between ASI and TRI was(21.58±0.02)%(t=48.799,P<0.05),the mean difference between ASI and PTRI was(2.95±0.03)%(t=2.100,P=0.151).Image quality of PTRI was obviously improved,and the diagnostic results of total 11 patients(11/29,37.93%) might be changed according to the results of PTRI,among them 6(6/29,20.69%) were confirmed by 2 doctors,3(3/29,10.34%) were confirmed by 3 doctors,another 2(2/29,6.90%) were confirmed by one doctor.The suspected diagnostic results decreased from 24 of ASI-TRI to 13 of ASI-PTRI(χ2=4.978,P=0.004).Conclusion The image quality of MI is improved,and the diagnostic objectivity may be increased by using the modified method of ASI-PTRI with 201Tl.更多还原