摘要
目的探讨适合心房^(18)F-FDG PET/CT显像的方法,并分析心房颤动(简称房颤)患者心房异常摄取的特征。方法前瞻性入组2017年8月至2018年8月间北京朝阳医院69例房颤患者[男43例,女26例,年龄(64±11)岁]行60及120 min ^(18)F-FDG PET/CT双时相显像。另招募10名健康志愿者为对照组[男3名,女7名,年龄(66±4)岁]行60 min ^(18)F-FDG PET/CT显像。采用美国核医学与分子影像学会/美国核心脏病学会/美国心血管计算机断层扫描学会(SNMMI/ASNC/SCCT)指南推荐的方法抑制心肌生理性摄取。图像分析:(1)左心室心肌^(18)F-FDG摄取情况定性分析:0级,左心室心肌摄取低于或等于心血池;1级,轻度高于心血池;2级,明显高于心血池。另观察左心房、左心耳和右心房的^(18)F-FDG摄取情况,高于心血池判定为异常摄取;采用配对χ^(2)检验比较早期相与延迟相各心房及心耳结构异常摄取的比例。(2)定量分析:测定左心房、左心耳、右心房的SUV_(max),并测定左右心房腔的SUV_(mean),计算左心房、左心耳及右心房的靶本比(TBR);采用Wilcoxon符号秩检验分析各心房及心耳结构早期相与延迟相TBR间的差异。采用χ^(2)检验及Mann-Whitney U检验比较房颤患者和对照组心房各结构^(18)F-FDG摄取差异。结果84.8%(67/79)的受试者左心室心肌生理性摄取被有效抑制,仅1例由于左心室摄取较高而影响对左心耳的判读。定性分析结果表明,左心房、右心房及左心耳延迟相异常摄取的比例均高于早期相,其中左心耳差异有统计学意义[27.9%(19/68)与42.6%(29/68);χ^(2)=8.10,P=0.020]。定量分析示,左心房、左心耳及右心房延迟相TBR均高于早期相TBR[左心房:1.1(1.0,1.3)与1.1(1.0,1.2);左心耳:1.2(1.0,1.5)与1.0(0.9,1.2);右心房:1.4(1.1,1.9)与1.3(1.0,1.5);z值:-6.81~-3.42,均P<0.05]。87.0%(60/69)的房颤患者存在心房异常摄取,明显高于对照组[0(0/10);χ^(2)=31.50,P<0.001],其中左心耳、右心房异常摄�
Objective To explore suitable strategies for atrial ^(18)F-FDG PET/CT imaging and analyze the characteristics of abnormal atrial uptake in patients with atrial fibrillation(AF).Methods From August 2017 to August 2018,69 AF patients(43 males,26 females,age(64±11)years)in Beijing Chaoyang Hospital were prospectively enrolled and underwent dual-phase ^(18)F-FDG PET/CT imaging(60 and 120 min postinjection).Additionally,10 healthy controls(3 males,7 females,age(66±4)years)were prospectively enrolled and underwent ^(18)F-FDG PET/CT imaging(60 min postinjection).A comprehensive strategy recommended by the Society of Nuclear Medicine and Molecular Imaging/American Society of Nuclear Cardiology/Society of Cardiovascular Computed Tomography(SNMMI/ASNC/SCCT)guideline was followed to suppress myocardial uptake.Image analysis:(1)^(18)F-FDG uptake of left ventricle was qualitatively analyzed and classified into 3 levels:grade 0,the activity of blood pool exceeded or was equal to myocardial activity;grade 1,myocardial activity was mildly higher than blood pool activity;grade 2,myocardial activity was obviously higher than blood pool activity.^(18)F-FDG uptake in the left atrium(LA),left atrial appendage(LAA)and right atrium(RA)higher than that in blood pool were defined as abnormal.Pairedχ^(2) test was used to compare the rates of abnormal uptake in atrial structures between two phases.(2)Quantitative analysis:^(18)F-FDG uptake in all atrial structures were quantitatively analyzed by measuring SUV_(max),and left atrial cavity and right atrial cavity were quantitatively analyzed by measuring SUV_(mean).The target to background ratio(TBR)was calculated.Differences of TBR between two phases were analyzed by Wilcoxon signed rank test.Differences of ^(18)F-FDG uptake in atrial structures between patients with AF and healthy controls were analyzed by Mann-Whitney U test andχ^(2) test.Results Most subjects(84.8%,67/79)achieved sufficient myocardial suppression.In one patient,the interpretation of LAA was affected by left ventricle
作者
陈碧希
武姣彦
谢博洽
杨敏福
Chen Bixi;Wu Jiaoyan;Xie Boqia;Yang Minfu(Department of Nuclear Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Cardiac Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第3期129-133,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金(81871380)。
