Subscribe to RSS
DOI: 10.1055/s-0030-1251999
© Georg Thieme Verlag KG Stuttgart · New York
Gated-SPECT – Integrierte kardiale Funktionsdiagnostik
Gated SPECT – Integrated Cardiac Functional WorkupPublication History
Publication Date:
31 May 2010 (online)
![](https://www.thieme-connect.de/media/nuklmed/201002/lookinside/thumbnails/10.1055-s-0030-1251999-1.jpg)
Zusammenfassung
Die EKG-getriggerte SPECT (gSPECT) stellt heute den aktuellen Stand der Technik in der Myokardperfusionsszintigrafie dar. Sie erlaubt ohne signifikanten Mehraufwand die zusätzliche Berechnung kardialer Funktionsparameter, beispielsweise der linksventrikulären Ejektionsfraktion, der linksventrikulären Volumina sowie der regionalen Wandbewegung und systolischen Wandverdickung. Die vorliegende Arbeit gibt einen Überblick über die Technik sowie die diagnostische und prognostische Relevanz des Verfahrens.
Abstract
Today, ECG-triggered SPECT (gSPECT) is the state of the art of myocardial perfusion imaging. It provides additional quantitative functional parameters such as left ventricular ejection fraction, left ventricular volumes, regional wall motion and wall thickening without significant additional effort. This review provides an overview over the gSPECT technique and the incremental diagnostic and prognostic value of gSPECT myocardial perfusion scintigraphy.
Schlüsselwörter
Gated-SPECT - Mykardperfusionsszintigrafie - Ejektionsfraktion
Key words
gated SPECT - myocardial perfusion - ejection fraction
Literatur
- 1 Berman DS, Hachamovitch R, Kiat H. et al . Incremental value of prognostic testing in patients with known or suspected ischemic heart disease: a basis for optimal utilization of exercise technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol. 1995; 26 639-647
- 2 Brown KA, Boucher CA, Okada RD. et al . Prognostic value of exercise thallium-201 imaging in patients presenting for evaluation of chest pain. J Am Coll Cardiol. 1983; 994-1001
- 3 Brown KA, Heller GV, Landin RS. et al . Early dipyridamole (99m)Tc-sestamibi single photon emission computed tomographic imaging 2–4 days after acute myocardial infarction predicts in-hospital and postdischarge cardiac events: comparison with submaximal exercise imaging. Circulation. 1999; 100 2060-2066
- 4 Choragudi NL, Prakash AM, 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
- 5 Cwajg E, Cwajg J, He ZX. et al . Gated myocardial perfusion tomography for the assessment of left ventricular function and volumes: comparison with echocardiography. J Nucl Med. 1999; 40 1857-1865
- 6 DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med. 1995; 36 952-955
- 7 Everaert H, Franken PR, Flamen P. et al . Left ventricular ejection fraction from gated SPET myocardial perfusion studies: a method based on the radial distribution of count rate density across the myocardial wall. Eur J Nucl Med. 1996; 23 1628-1633
- 8 Faber TL, Cooke CD, Folks RD. et al . Left ventricular function and perfusion from gated SPECT perfusion images: an integrated method. J Nucl Med. 1999; 40 650-659
- 9 Fintel DJ, Links JM, Brinker JA. et al . Improved diagnostic performance of exercise thallium-201 single photon emission computed tomography over planar imaging in the diagnosis of coronary artery disease: a receiver operating characteristic analysis. J Am Coll Cardiol. 1989; 13 600-612
- 10 Fleischmann S, Koepfli P, Namdar M. et al . Gated (99m)Tc-tetrofosmin SPECT for discriminating infarct from artifact in fixed myocardial perfusion defects. J Nucl Med. 2004; 45 754-759
- 11 Germano G, Erel J, Lewin H. et al . Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol. 1997; 30 1360-1367
- 12 Germano G, Kiat H, Kavanagh PB. et al . Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med. 1995; 36 2138-2147
- 13 Germano G, Kiat H, Kavanagh PB. et al . Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med. 1995; 36 2138-2147
- 14 Gibson RS, Watson DD, Craddock GB. et al . Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. Circulation. 1983; 68 321-336
- 15 Hesse B, Lindhardt TB, Acampa W. et al . EANM/ESC guidelines for radionuclide imaging of cardiac function. Eur J Nucl Med Mol Imaging. 2008; 35 851-885
- 16 Ioannidis JP, Trikalinos TA, Danias PG. 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
- 17 Kiat H, Berman DS, Maddahi J. Comparison of planar and tomographic exercise thallium-201 imaging methods for the evaluation of coronary artery disease. J Am Coll Cardiol. 1989; 13 613-616
- 18 Klocke FJ, Baird MG, Lorell BH. et al . ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging – executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). J Am Coll Cardiol. 2003; 42 1318-1333
- 19 Ladenheim ML, Pollock BH, Rozanski A. et al . Extent and severity of myocardial hypoperfusion as predictors of prognosis in patients with suspected coronary artery disease. J Am Coll Cardiol. 1986; 7 464-471
- 20 Lindner O, Burchert W, Bengel FM. et al . Myocardial perfusion scintigraphy 2007 in Germany – results of the query and current status. Nuklearmedizin. 2009; 48 131-137
- 21 Mahmarian JJ, Shaw LJ, Filipchuk NG. et al . A multinational study to establish the value of early adenosine technetium-99m sestamibi myocardial perfusion imaging in identifying a low-risk group for early hospital discharge after acute myocardial infarction. J Am Coll Cardiol. 2006; 48 2448-2457
- 22 Moss AJ, Zareba W, Hall WJ. et al . Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002 Mar 21; 346 (12) 877-883
- 23 Patel CD, Nadig MR, Kurien S. et al . Left ventricular ejection fraction and volumes on rest gated 201Tl perfusion SPECT: comparison with two-dimensional echocardiography. Nucl Med Commun. 2006; 27 425-429
- 24 Paul AK, Nabi HA. Gated myocardial perfusion SPECT: basic principles, technical aspects, and clinical applications. J Nucl Med Technol. 2004; 32 179-187 ;188–189
- 25 Schaefer WM, Lipke CS, Standke D. et al . Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med. 2005; 46 1256-1263
- 26 Schäfers M, Bengel F, Büll U. et al . Position paper nuclear cardiology: update 2008. Nuklearmedizin. 2009; 48 71-78
- 27 Sharir T, Germano G, Kavanagh PB. 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
- 28 Sharir T, Kang X, Germano G. et al . Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: gender-related differences in normal limits and outcomes. J Nucl Cardiol. 2006; 13 495-506
- 29 Shaw LJ, Hachamovitch R, Berman DS. et al . The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group. J Am Coll Cardiol. 1999; 33 661-669
- 30 Smanio PE, Watson DD, Segalla DL. et al . Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging. J A Coll Cardiol. 1997; 30 1687-1692
- 31 Stollfuss JC, 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
- 32 Underwood SR, Anagnostopoulos C, Cerqueira M. et al . Myocardial perfusion scintigraphy: the evidence. Eur J Nucl Med Mol Imaging. 2004; 31 261-291
- 33 Underwood SR, Godman B, Salyani S. et al . Economics of myocardial perfusion imaging in Europe-the EMPIRE Study. Eur Heart J. 1999; 20 157-166
- 34 White HD, Norris RM, Brown MA. et al . Effect of intravenous streptokinase on left ventricular function and early survival after acute myocardial infarction. N Engl J Med. 1987; 317 850-855
Korrespondenzadresse
Dr. Kambiz Rahbar
Klinik und Poliklinik für
Nuklearmedizin
Universitätsklinikum Münster
Albert-Schweitzer-Straße 33
48149 Münster
Phone: +49/251/834 7362
Fax: +49/251/834 7363
Email: rahbar@uni-muenster.de