대한핵의학회지 (1967년~2009년)
대한핵의학회지 2003;37(6)355~363
게이트 심근 SPECT를 이용한 좌심실의 국소탄성률 평가방법 개발 및 재현성 평가
(Development of Evaluation Method of Regional Contractility of Left Ventricle Using Gated Myocardial SPECT and Assessment of Reproducibility)
Author 이병일,이동수,이재성,강원준,정준기,이명철,최흥국,
Byeong Il Lee, Dong Soo Lee, Jae Sung Lee, Won Jun Knag, June-Key Chung,Myung Chul Lee, Heung Kook Choi
Affiliation 인제대학교 정보컴퓨터공학부,서울대학교의과대학 핵의학교실
Department of Information & Computer Engineering, Inje University, Kimhae, Korea
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
Abstract

Purpose: Regional contractility can be calculated using the regional volume change of left ventricle measured by gated myocardial SPECT image and curve of central artery pressure obtained from radial artery pressure data. In this study, a program to obtain the regional contractility was developed, and reproducibility of regional contractility measurement was assessed. Materials and Methods: Seven patients (male:female=5:2, 58±11.9 years) with coronary artery diseases underwent gated Tc-99m MIBI myocardial SPECT twice without delay between two scans. Regional volume change of left ventricle was estimated using CSA (Cardiac SPECT Analyzer) software developed in this study. Regional contractility was iteratively estimated from the time-elastance curve obtained using the time-pressure curve and regional time-volume curve. Reproducibility of regional contractility measurement assessed by comparing the contractility values measured twice from the same SPECT data and by comparing those measured from the pair of SPECT data obtained from a same patient. Results: Measured regional contractility was 3.36 ± 3.38 ㎜Hg/mL using 15-segment model, 3.16 ± 2.25 ㎜Hg/mL using 7-segment model, and 3.11 ± 2.57 ㎜Hg/mL using 5-segment model. The harmonic average of regional contractility value was almost identical to the global contractility. Correlation coefficient of regional contractility values measured twice from the same data was greater than 0.97 for all models, and two standard deviations of contractility difference on Bland Altman plot were 1.5%, 1.0%, and 0.9% for 15-, 7-, and 5-segment models, respectively. Correlation coefficient of regional contractility values measured from the pair of SPECT data obtained from a same patient was greater than 0.95 for all models, and two standard deviations on Bland Altman plot were 2.2%, 1.0%, and 1.2%. Conclusion: Regional contractility of left ventricle measured using developed software in this study was reproducible. Regional contractility of left ventricle will be a new useful index for myocardial function after analysis of the clinical data.

Keyword gated myocardial SPECT, contractility, regional Emax
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