대한핵의학회지 (1967년~2009년)
대한핵의학회지 2005;39(6)430~437
게이트 심근 관류 스펙트의 심기능 지표의 정상 참고값 : QGS? 프로그램과 4DM? 프로그램의 비교
(Reference Values of Functional Parameters in Gated Myocardial Perfusion SPECT : Comparison with QGS? and 4DM? Program)
Author 정영진1,박태호2,차광수2,김무현2,김영대2,강도영1,
Young Jin Jeong1, Tae Ho Park2, Kwang Soo Cha2, Moo Hyun Kim2, Young Dae Kim2, Do-Young Kang1
Affiliation 동아대학교 의과대학 핵의학교실1, 내과학교실2
School of Nuclear Medicine1 and Internal Medicine2, Dong-A University College of Medicine, Busan, Korea
Abstract

Purpose: The objectives of this study were - First, to determine the normal range of left ventricular end diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) from gated myocardial perfusion SPECT for Quantitative Gated SPECT (QGS) and 4D-MSPECT (4DM), respectively. Second, to evaluate the relationships between values produced by both software packages. Materials & Methods: Tc-99m MIBI gated myocardial perfusion SPECT were performed for 77 patients (mean age: 49.6±13.7y, n=37(M), 40(F)) with a low likelihood (<10%) of coronary artery disease (CAD) using dual head gamma camera (E.CAM, Siemens, USA). Left ventricular EDV, ESV and EF were automatically measured by means of QGS and 4DM, respectively. Results: In QGS, the mean EDV, ESV and EF for all patients were 78.2±25.2ml, 27.4±12.9ml and 66.6±8.0% at stress test respectively, not different from rest test (p>0.05). In 4DM, the mean EDV, ESV and EF for all patients were 89.1±26.4ml, 29.1±12.8ml and 68.5±6.7% at stress test. Most cases in 4DM, there was no significant difference statistically between stress and rest test (p>0.05). But statistically significant difference was found in EF (68.5±6.7% at stress vs 70.9±8.0% at rest, p<0.05). Correlation coefficients between the methods for EDV, ESV and EF were comparatively high (0.95, 0.93, 0.71 at stress test and 0.95, 0.90, 0.69 at rest test, respectively). However, Bland-Altman plots showed a large range of the limit value of agreement for EDV, ESV and EF between both methods (-30ml∼10ml, -12ml∼8ml, -14%∼11% at stress test and -32ml∼5ml, -13ml∼13ml, -18%∼12% at rest test). Conclusion: We found the normal ranges of EDV, ESV and EF for patients with a low likelihood of CAD in both methods. We expect these values will be a good reference to interpret gated myocardial perfusion SPECT. Although good correlation was observed between both methods, they should not be used interchangeably. Therefore, when both programs are used at the same site, it will be important to apply normal limits specific to each method.(Korean J Nucl Med 39(6):430-437, 2005)

Keyword Tc-99m MIBI, Gated myocardial perfusion SPECT, QGS, 4DM, Normal limits
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