rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2019-100-3-152-160rentrad-469Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHОценка точности вычисления показателей гемодинамики и массы миокарда левого желудочка по данным ЭКГ-синхронизированной перфузионной сцинтиграфии миокарда: сравнение с многосрезовой компьютерной томографией сердцаAssessment of Accuracy in Calculating Hemodynamic Parameters and Left Ventricular Mass According to ECG-Synchronized Myocardial Perfusion Scintigraphic Data: Comparison with Cardiac Multislice Computed Tomographyhttps://orcid.org/0000-0001-5564-3802СаушкинВ. В.SaushkinV. V.

Саушкин Виктор Вячеславович - кандидат медицинских наук, старший научный сотрудник.

ул. Киевская, 111а, Томск, 634012.

Viktor V. Saushkin - Cand. Med. Sc., Senior Researcher, Cardiology Research Institute.

ul. Kievskaya, 111a, Tomsk, 634012.

vitversus@gmail.comhttps://orcid.org/0000-0002-1513-8614ЗавадовскийК. В.ZavadovskiyK. V.

Завадовский Константин Валерьевич - доктор медицинских наук, руководитель лаборатории радионуклидных методов исследования.

ул. Киевская, 111а, Томск, 634012.

Konstantin V. Zavadovskiy - Dr. Med. Sc., Head of Laboratory of Radionuclide Methods of Study, Cardiology Research Institute.

ul. Kievskaya, 111a, Tomsk, 634012.

Научно-исследовательский институт кардиологии ФГБНУ «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияCardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of SciencesRussian Federation2019260620191003152160Copyright © Саушкин В.В., Завадовский К.В., 20192019Саушкин В.В., Завадовский К.В.Saushkin V.V., Zavadovskiy K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/469

Цель исследования – оценить точность вычисления значений конечного диастолического  (КДО), конечного систолического  (КСО) объемов, фракции выброса (ФВ) и массы миокарда левого желудочка (ЛЖ), полученных по данным ЭКГ-синхронизированной перфузионной сцинтиграфии миокарда (ЭКГ-ПСМ), на CZT-камере, в сравнении с многосрезовой компьютерной томографией (МСКТ) сердца.

Материал  и методы

Материал  и методы. Были обследованы 34 пациента (средний возраст 62 ± 5 лет) с подозрением на ишемическую болезнь сердца (ИБС) или ранее установленным диагнозом ИБС. Всем пациентам была выполнена МСКТ-ангиография  коронарных артерий и перфузионная сцинтиграфия миокарда с 99mTc-МИБИ. Для сравнительного анализа были использованы значения КДО, КСО, ФВ и массы миокарда ЛЖ, определенные по данным ЭКГ-ПСМ в покое и МСКТ сердца. Исследования были проведены на гибридном 64-срезовом ОЭКТ/КТ-томографе Discovery 570c (GE Healthcare, США).

Результаты

Результаты. При анализе результатов обоих методов были выявлены статистически значимые различия в значениях КДО (МСКТ: 168 (145–210) мл, ЭКГ-ПСМ: 112 (94–141) мл; p < 0,05), КСО (МСКТ: 72 (49–83) мл, ЭКГ-ПСМ:  44 (32–66)  мл; p < 0,05) и массы ЛЖ (МСКТ:  123 (107–143)  г, ЭКГ-ПСМ:  140 (124–168)  г; p < 0,05). Значения ФВ левого желудочка (МСКТ: 64 (54–69)%, ЭКГ-ПСМ: 61 (50–66)%; p > 0,05) значимо не различались. Была выявлена статистически значимая корреляция значений КДО, КСО и массы миокарда ЛЖ (r = 0,81, r = 0,78, r = 0,82 соответственно; p < 0,05) и средняя корреляция ФВ  ЛЖ (r = 0,66, p < 0,05). При проведении анализа Бланда–Альтмана значения КДО, КСО и массы миокарда ЛЖ имели статистически значимые различия. Границы согласованности для показателей были следующими:  КДО 9–105 мл, КСО 9–55 мл, масса миокарда ЛЖ 51,6–20,7 г. Согласованность в измерении была выявлена только для ФВ (границы согласия 16,9–18,4%, p < 0,05). Были вычислены уравнения линейной регрессии, позволяющие получить точные значения объемных показателей и массы миокарда ЛЖ по данным ЭКГ-ПСМ.

Заключение

Заключение. Сцинтиграфический метод по сравнению с МСКТ показывает значимо меньшие объемы (КДО и КСО) и большие значения массы миокарда левого желудочка. Значения КДО, КСО, ФВ и массы миокарда ЛЖ, вычисленные  при помощи ЭКГ-ПСМ, имеют статистически значимую сильную корреляцию с результатами МСКТ. При этом хорошая согласованность результатов измерения была выявлена только для фракции выброса ЛЖ.

Objective

Objective. To assess accuracy in calculating the values of end-diastolic and end-systolic volumes (EDV and ESV), ejection fraction (EF), and left ventricular (LV) mass, which are obtained according to ECG-synchronized myocardial perfusion scintigraphy (ECG-MPS) on a CZT  camera versus those of cardiac multislice computed tomography (MSCT).

Material and methods

Material and methods. Thirty-four patients (mean age, 62 ± 5 years) with suspected coronary heart disease or its previously established diagnosis were examined. All the patients underwent MSCT coronary angiography and myocardial perfusion scintigraphy with 99mTc-methyxy-isobutyl-isonitrile. For a comparative analysis, the investigators used the EDV, ESV, FV and LV mass values determined by ECG-MPS at rest and cardiac MSCT. The studies were conducted on a 64-slice SPECT/CT hybrid scanner (Discovery 570c, GE Healthcare, USA).

Results

Results. The analysis of the results obtained by both methods revealed statistically significant differences in the values of EDV (MSCT: 168 (145–210) ml; ECG-MPS: 112 (94–141) ml; p < 0.05), ESV (MSCT: 72 (49–83) ml; ECG-MPS: 44 (32–66)  ml; p < 0.05), and LV  mass (MSCT:  123 (107–143)  g; ECG-MPS: 140 (124–168)  g; p < 0.05).  There were no significant differences in LV EF  (MSCT:  64 (54–69)%; ECG-MPS: 61 (50–66)%; p > 0.05).  There was a statistically  significant correlation between the values of EDV,  ESV,  and LV  mass (r = 0.81; r = 0.78; r = 0.82, respectively, p < 0.05) and a mean correlation of LV EF  (r = 0.66; p < 0.05). The Bland–Altman analysis showed that the values of EDV, ESV, and LV mass had statistically significant differences. The consistency limits for the indicators were as follows: EDV, 9–105 ml; ESV, 9–55 ml; LV  mass, 51.6–20.7  g. There was a measurement consistency only for EF  (consent  limits, 16.9–18.4%; p < 0.05). Linear regression equations were calculated, which allow determination  of exact values for the volume indices and LV mass according ECG-MPS data.

Conclusion

Conclusion. The scintigraphic method versus MSCT yields significantly smaller volumes (EDV and ESV) and higher LV mass. The  ECG-MPS values for EDV, ESV, EF, and LV mass have a statistically significant strong correlation with MSCT findings. At the same time, a good consistency of measurements was found only for LV EF.

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The authors declare that there are no conflicts of interest present.