Zusammenfassung
Im Rahmen der myokardialen Perfusionsdiagnostik erlaubt die herzphasengetriggerte
SPECT-Akquisition ohne relevanten Mehraufwand die Bestimmung der Wandbewegung und
-verdickung sowie die Berechnung der enddiastolischen und endsystolischen linksventrikulären
Ventrikelvolumina und der Ejektionsfraktion. Der vorliegende Artikel gibt einen Überblick
über Technik und Fallgruben der gated-SPECT und die Validität der mit dieser Technik
erhobenen Daten und Befunde. Darüber hinaus wird die diagnostische und prognostische
Relevanz des Verfahrens anhand klinischer Studien dargelegt.
Abstract
When used for myocardial perfusion imaging, ECG-gated SPECT acquisition yields wall
motion, wall thickening, end-diastolic and end-systolic left ventricular volumes and
ejection fraction to be calculated without a greater additional effort. This paper
gives an overview of the methods and pitfalls of gated SPECT and the validity of data
and findings obtained with this method. Also, the method’s diagnostic and prognostic
relevance are shown by means of clinical studies.
Schlüsselwörter
Myokardperfusionsszintigraphie - SPECT - EKG-Triggerung - gated-SPECT - linksventrikuläre
Funktion
Key words
Myocardial perfusion scintigraphy - SPECT - ECG-gating - gated SPECT - left ventricular
function
Literatur
- 1
Atsma D E, Bavelaar-Croon C D, Germano G. et al .
Good correlation between gated single photon emission computed myocardial tomography
and contrast ventriculography in the assessment of global and regional left ventricular
function.
Int J Card Imaging.
2000;
16
447-453
- 2
Choragudi N L, Prakash A M, Sun Y. et al .
Comparison of echocardiography with technetium 99m-gated single photon emission computed
tomography as diagnostic tools for left ventricular ejection fraction.
Echocardiography.
2001;
18
627-632
- 3
DePuey E G, Rozanski A.
Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects
as infarct or artifact.
J Nucl Med.
1995;
36
952-955
- 4
Ficaro E P, Quaife R A, Kritzman J N. et al .
Accuracy and reproducibility of 3D-MSPECT for estimating left ventricular ejection
fraction in patients with severe perfusion abnormalities [abstract].
Circulation.
1999;
100 (Suppl I)
26
- 5
Germano G, Kiat H, Kavanagh P B, Chen J. et al .
Automatic quantification of ejection fraction from gated myocardial perfusion SPECT.
J Nucl Med.
1995;
36
2138-2147
- 6
Hashimoto J, Kubo A, Iwasaki R. et al .
Gated single-photon emission tomography imaging protocol to evaluate myocardial stunning
after exercise.
Eur J Nucl Med.
1999;
26
1541-1546
- 7
Ioannidis J P, Trikalinos T A, Danias P G.
Electrocardiogram-gated single-photon emission computed tomography versus cardiac
magnetic resonance imaging for the assessment of left ventricular volumes and ejection
fraction: a meta-analysis.
J Am Coll Cardiol.
2002;
39
2059-2068
- 8
Johnson L L, Verdesca S A, Aude W Y. et al .
Postischemic stunning can affect left ventricular ejection fraction and regional wall
motion on post-stress gated sestamibi tomograms.
J Am Coll Cardiol.
1997;
30
1641-1648
- 9
Kumita S, Cho K, Nakajo H. et al .
Assessment of left ventricular diastolic function with electrocardiography-gated myocardial
perfusion SPECT: comparison with multigated equilibrium radionuclide angiography.
J Nucl Cardiol.
2001;
8
568-574
- 10
Lipke C, Kühl H P, Nowak B, Kaiser H-J, Reinartz P, Koch K C, Buell U, Schaefer W M.
Validation of 4D-MSPECT and QGS for Quantification of Left Ventricular Volumes and
Ejection Fraction from Gated 99mTc-MIBI SPET: Comparison with Cardiac Magnetic Resonance Imaging.
Eur J Nucl Med Mol Imaging.
2004;
31
482-490
- 11
Schaefer W M, Lipke C, Nowak B. et al .
Validation of QGS and 4D-MSPECT for Quantification of Left Ventricular Volumes and
Ejection Fraction from Gated 18F-FDG PET: Comparison with Cardiac MRI.
J Nucl Med.
2004;
45
74-79
- 12
Schaefer W M, Lipke C, Nowak B. et al .
Validation of an evaluation routine for left ventricular volumes, ejection fraction
and wall motion from gated cardiac FDG PET: a comparison with cardiac magnetic resonance
imaging.
Eur J Nucl Med Mol Imaging.
2003;
30
545-553
- 13
Sharir T, Bacher-Stier C, Dhar S. et al .
Identification of severe and extensive coronary artery disease by postexercise regional
wall motion abnormalities in Tc-99m sestamibi gated single photon emission computed
tomography.
Am J Cardiol.
2000;
86
1171-1175
- 14
Sharir T, Germano G, Kavanagh P B. et al .
Incremental prognostic value of post-stress left ventricular ejection fraction and
volume by gated myocardial perfusion single photon emission computed tomography.
Circulation.
1999;
100
1035-1042
- 15
Stollfuss J C, Haas F, Matsunari I. et al .
99mTc-tetrofosmin SPECT for prediction of functional recovery defined by MRI in patients
with severe left ventricular dysfunction: additional value of gated SPECT.
J Nucl Med.
1999;
40
1824-1831
- 16
White H D, Norris R M, Brown M A. et al .
Left ventricular end-systolic volume as the major determinant of survival after recovery
from myocardial infarction.
Circulation.
1987;
76
44-51
- 17
Yamaguchi A, Ino T, Adachi H. et al .
Left ventricular volume predicts postoperative course in patients with ischemic cardiomyopathy.
Ann Thorac Surg.
1998;
5
434-438
Dr. med. Dr. rer. medic. Dipl.-Phys. Wolfgang M. Schäfer
Klinik für Nuklearmedizin · Universitätsklinikum Aachen
Pauwelsstr. 30
52074 Aachen
Email: wschaefer@ukaachen.de