scholarly journals Сравнительный анализ данных перфузионной сцинтиграфии миокарда у пациентов с поражением коронарных артерий различной степени выраженности

2019 ◽  
Author(s):  
E DENISENKO-KANKIYA ◽  
F.N. CHANAKHCHIAN ◽  
E.I. VASILENKO ◽  
M.N. VAKHROMEEVA
Keyword(s):  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Vulnerable Atherosclerotic Plaque ◽  
Gated Perfusion Spect ◽  
Perfusion Spect ◽  
Perfusion Defects ◽  
Reversible Ischemia ◽  
Myocardial Perfusion Defects

Известно, что дестабилизация атеросклеротической бляшки коронарных артерий (КА) играет ключевую роль в развитии осложнений хронической ишемической болезни сердца (ИБС). Ранняя диагностика ишемии миокарда и определение субклинического стеноза КА с помощью неинвазивного метода визуализации сердца может стать важным методом в предотвращении развития сердечно-сосудистых осложнений у данной популяции больных. Цель исследования. Определить выраженность преходящих нарушений перфузии миокарда, выявленных при однофотонной эмиссионной компьютерной томографии (ОЭКТ) миокарда у пациентов со стенозами КА различной степени тяжести. Материал и методы. В исследование включен 231 пациент (средний возраст 6210лет). Проанализированы факторы кардиального риска. Всем пациентам проводили ОЭКТ миокарда по стандартному протоколу. Региональную перфузию миокарда оценивали с использованием стандартизированной 20-сегментной модели, на которой оценивали: SSS общий счет снижения перфузии миокарда при нагрузке SDS общую разницу счета, соответствующую степени выраженности преходящей ишемии левого желудочка (ЛЖ). На основании полученных данных обследуемых пациентов классифицировали на группы: с нормальной перфузией (SSS4), незначительной (SSS4-6), умеренной и выраженной степенью снижения (SSS712 и SSS13 соответственно) перфузии миокарда ЛЖ. Результаты SDS классифицировали как: отсутствие ишемии (SDS2), умеренная преходящая ишемия (SDS2-6) и выраженная преходящая ишемия (SDS7). Количественные показатели перфузии миокарда сравнивали с результатами инвазивной коронароангиографии (КАГ). Результаты. Из 231 пациента у 69 (29,9) по данным КАГ были выявлены стенозы до 20, у 126 (54,5) стенозы 2049, у 36 (15,6) стенозы 50 и более. Сравнительный анализ количественных показателей перфузии миокарда (SSS и SDS) и результатов КАГ показал, что достоверные дефекты перфузии после нагрузки и преходящая ишемия ЛЖ определены в основном у пациентов со стенозами КА50 (47,2 и 63,9 соответственно, р0,01). В группе пациентов с стенозами КА 2049 у 42,1 показатели SSS соответствовали незначительной (25,4) и умеренной (16,7) степени снижения перфузии после нагрузки (р0,01). При сопоставлении данных перфузионной сцинтиграфии миокарда выявлена связь между показателем SSS, наличием факторов риска и наличием сопутствующих заболеваний у пациентов с ИБС (р0,05). Заключение. Перфузионная ОЭКТ миокарда может использоваться в качестве метода выявления преходящей ишемии миокарда у пациентов со стенозами КА различной тяжести. Ключевые слова: ишемическая болезнь сердца, однофотонная эмиссионная компьютерная томография, перфузия миокарда, сцинтиграфия миокарда, необструктивное поражение, обструктивное поражение, коронароангиография.Vulnerable atherosclerotic plaque in coronary arteries (CA) is the primary mechanism responsible for complications of CAD even in the terms of non-obstructive CAD. Early determination of myocardial ischemia and CA stenosis with non-invasive imaging technique could predict the development of major cardiac events in patients with CAD. Aim: evaluation the severity of myocardial perfusion defects with single photon emission computed tomography (SPECT) in patients with obstructive or non-obstructive CAD. Material and methods: Overall 231patients (average age of 6210) were analyzed. All patients underwent 1-day gated perfusion SPECT protocol before coronary angiography (CAG). SPECT images were quantified by SSS and SDS using Cedars-Sinai QPS. Normal myocardial perfusion was considered if SSS4 mildly abnormal: SSS4-7 moderate and significantly abnormal: SSS8-12 and SSS13, respectively. Reversible ischemia was defined as SDS2. Degree of ischemia was assessed to moderate (SDS2-7) and severe (SDS7). Obstructive CAD was defined as 50 stenosis in 1 vessel on CAG. Results: From 231 patients 69 (29,9) have non-significant CA stenosis (20), 126 (54,5) have non-obstructive CAD (20-49) and 36 (15,6) - obstructive CAD (50). There were significant differences between CA stenosis severity via CAG and SSS via SPECT. In obstructive CAD significant myocardial perfusion defect at stress (SSS) and reversible ischemia (SDS) were observed in 47,2 and 63,9 patients, respectively (p0,01). In patients with non-obstructive CAD although the majority has normal myocardial perfusion in stress (SSS4 55,6), 42,1 has both mild (25,4) and moderate (16,7) myocardial perfusion defects in stress (p0,001). In this subgroup 45,2 of patients have moderate and 18,3 - severe reversible ischemia according to SDS (p0,001). Abnormal perfusion in stress was associated with hazards of cardiac risk factors or associated diseases (p0,05). Conclusion: Perfusion SPECT has a prognostic value over invasive CAG. The addition SPECT quantitative analysis to CAG allows improved risk stratification of patients with non-obstructive CAD.

scholarly journals Prognostic Significance of Myocardial Ischemia Detected by Single-Photon Emission Computed Tomography in Children with Hypertrophic Cardiomyopathy

2021 ◽  
Author(s):  
Lidia Ziolkowska ◽  
Agnieszka Boruc ◽  
Dorota Sobielarska-Lysiak ◽  
Agnieszka Grzyb ◽  
Joanna Petryka-Mazurkiewicz ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Myocardial Ischemia ◽  
Myocardial Fibrosis ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Perfusion Defects ◽  
Single Photon Emission Computed ◽  
Myocardial Perfusion Defects ◽  
Photon Emission Computed Tomography

AbstractMyocardial ischemia caused by microvascular dysfunction is an important pathophysiologic component of hypertrophic cardiomyopathy (HCM), promoting myocardial fibrosis, adverse left ventricular remodeling, and impacting on clinical course and outcome in HCM patients. The aim of study was to assess the prevalence and clinical significance of myocardial ischemia in children with HCM using 99mTc-MIBI single-photon emission computed tomography (SPECT). Ninety-one children with HCM, median age 13.6 years, underwent SPECT evaluation from 2006 to 2017. Imaging was performed at rest and after maximal exercise. Myocardial perfusion defects were identified in 70 children (76.9%; group I), median age 13.8 years. Fixed perfusion defects were evident in 22 of them, while reversible at rest in 48. In 21 children (23.1%; group II), median age 11 years, myocardial perfusion defects were not detected. Patient demographics, echocardiography, resting electrocardiogram (ECG), 24-h Holter ECG, myocardial fibrosis in cardiovascular magnetic resonance imaging, and cardiovascular events were analyzed and compared between the groups. During follow-up at a median of 8.3 years in children with myocardial ischemia, clinical endpoints occurred more often (47 vs. 5; p = 0.02) and more patients reached a clinical endpoint (28 [40%] vs. 3 [14.3%]; p = 0.036). In children with myocardial ischemia, myocardial fibrosis was observed with greater frequency. Myocardial perfusion defects may reflect an ischemic process which (1) affects the clinical manifestations and (2) is an important predictor of adverse clinical events and risk of death in children with HCM. Myocardial ischemia in HCM patients frequently correlates with myocardial fibrosis.

Abstract 4211: Depth of Myocardial Bridges on Computed Tomographic Angiography is Associated with Myocardial Perfusion Defects on Single Photon Emission Computed Tomography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
James J Jang ◽  
Ashok Krishnaswami ◽  
Mateo Go ◽  
Kenneth S Battaglia
Keyword(s):  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Computed Tomographic Angiography ◽  
Emission Computed Tomography ◽  
Myocardial Bridges ◽  
Spect Mpi ◽  
Computed Tomographic ◽  
Cardiac Cta ◽  
Perfusion Defects

Although considered a relatively benign congenital coronary anomaly, myocardial bridges have been associated with myocardial ischemia, infarctions, and sudden cardiac death. The aim of this study was to identify characteristics of myocardial bridges on computed tomographic angiography (CTA) associated with abnormal defects on myocardial perfusion imaging (MPI). A retrospective study was performed to identify patients who had myocardial bridges detected by 64-slice multidetector cardiac CTA and prior stress single photon emission computed tomography (SPECT) MPI. Using axial, oblique, and curved multi-planar reformatted images, myocardial bridge characteristics, including length and maximum depth of the tunneled segments, were compared in patients with and without corresponding coronary perfusion defects on SPECT MPI. From a total of 272 patients who had both SPECT MPI and cardiac CTA performed, 23 patients (8%, males= 9, mean age= 57 years) were identified with myocardial bridges. The left anterior descending artery was the predominant affected coronary artery (20/23, 87%). Eight patients (35%) with myocardial bridges had corresponding perfusion defects on SPECT MPI. Increased depth of the tunneled segment was significantly associated with abnormal SPECT MPI compared to normal SPECT MPI (4.1 ± 2.0mm vs. 1.9 ± 0.9mm, respectively, p< 0.002). The length of the tunneled segment did not differ in patients with or without abnormal SPECT MPI (27.8 ± 15.6mm vs. 20.9 ± 12.6mm, respectively, p=0.26). This is the first study to correlate SPECT MPI and 64-slice multidetector cardiac CTA in the evaluation of myocardial bridges. Increased maximum depth of the tunneled segment on cardiac CTA is significantly associated with myocardial perfusion defects.

scholarly journals Quantitative analysis of gated myocardial perfusion SPECT

2018 ◽  
pp. 220-227
Author(s):  
Victor Ploskikh ◽  
Elena Kotina
Keyword(s):  
Quantitative Analysis ◽  
Myocardial Perfusion ◽  
Data Processing ◽  
Single Photon ◽  
Photon Emission ◽  
Myocardial Perfusion Spect ◽  
Mathematical Representation ◽  
Emission Computed Tomography ◽  
Gated Myocardial Perfusion Spect ◽  
Perfusion Spect

The paper considers the problem of gated myocardial perfusion single photon emission computed tomography (SPECT) data processing. An approach to the quantitative analysis of gated myocardial perfusion SPECT data used in software developed in the SPbSU is presented. The article presents and formalizes the complete data processing workflow. All the main tasks of the data processing are considered. Mathematical representation of problem domain objects is presented. A detailed algorithm of the data processing is given. The algorithmis implemented as component of the data processing software suite.

Nuclear imaging

2019 ◽  
pp. 159-162
Author(s):  
Stefan Möhlenkamp
Keyword(s):  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Nuclear Imaging ◽  
Emission Computed Tomography ◽  
Invasive Method ◽  
Perfusion Defects ◽  
Artery Disease ◽  
Exercise Induced ◽  
And Function

Myocardial perfusion imaging using single photon emission computed tomography (SPECT) by means of scintigraphy is an established non-invasive method for detecting coronary artery disease (CAD) and improving risk stratification in symptomatic individuals. Data on its diagnostic and prognostic role and value in athletes are sparse. Possibly in part due to exercise-induced improved myocardial microvascular morphology and function, a mismatch between advanced coronary atherosclerosis burden and comparatively small myocardial perfusion defects has been reported in athletes. Because of radiation exposure and the costs of the test a careful risk–benefit assessment is necessary, particularly in asymptomatic athletes with risk factors and young athletes.

scholarly journals Challenges of gated myocardial perfusion SPECT processing

2021 ◽  
pp. 171-177
Author(s):  
Victor Ploskikh ◽  
Elena Kotina
Keyword(s):  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Myocardial Perfusion Spect ◽  
Mathematical Representation ◽  
Emission Computed Tomography ◽  
Gated Myocardial Perfusion Spect ◽  
Myocardial Perfusion Single Photon ◽  
Perfusion Spect ◽  
Photon Emission Computed Tomography

The paper provides an in-depth look at gated myocardial perfusion single photon emission computed tomography (SPECT) data processing. Attention paid to several unmentioned subjects of the quantitative analysis of gated myocardial perfusion SPECT data. The article considers several options in the construction process of the ellipsoid coordinate system of the left ventricle (LV). Mathematical representation of polar maps is given. Formulas of the regional parameters calculation are proposed. Issues of phase analysis are explored.

scholarly journals Radiomics analysis of myocardial perfusion SPECT images in patients with cardiomyopathy and heart failure

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
K Okuda ◽  
K Nakajima ◽  
H Saito ◽  
S Yamashita ◽  
M Hashimoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Myocardial Perfusion Spect ◽  
Feature Reduction ◽  
Support Vector ◽  
Emission Computed Tomography ◽  
Operating Characteristics ◽  
Perfusion Spect

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI Grants Background Although myocardial perfusion heterogeneity due to focally damaged cardiomyocytes is observed in single−photon emission computed tomography (SPECT) imaging, a current perfusion defect scoring system does not allow us to provide sufficient diagnostic information for heterogeneity. Purpose The aim of this study was to perform radiomics analysis of myocardial perfusion SPECT (MPS) images to investigate the potential to detect myocardial perfusion heterogeneity. Methods Patients with hypertrophic cardiomyopathy (n = 3), heart failure (n = 9), and with a low likelihood of coronary artery disease (n =15) (Figure 1), who underwent a rest 99mTc-MIBI myocardial perfusion SPECT, were assessed using a LIFEx software. Four shape−based features, 6 histogram−based features, and 32 textural features were computed. The relevant features for the classification of the patients were selected using the Boruta algorithm, and hierarchical clustering of the selected features using the Spearman correlation coefficient was also performed for the feature reduction. The receiver operating characteristics (ROC) analysis was performed by the support vector machine to calculate the area under the ROC curve (AUC) for the selected features. Results Of 40 features, 17 were selected by the classification analysis, and these features were classified into 7 classes by the correlation analysis (Figure 2). The ROC AUCs for 7 features extracted from each class were 0.99, 0.97, 0.96, 0.92, 0.90, 0.86, and 0.83 for the contrast of NDGLDM, the entropy of histogram, ZLNU of GLZLM, the energy of GLCM, the energy of histogram, SZLGE of GLZLM, and the correlation of GLCM, respectively, as compared to 0.39 for a summed rest score. Conclusions Radiomics analysis successfully determined the myocardial perfusion heterogeneity in patients with cardiomyopathy and heart failure. It might be promising for the evaluation of myocardial damages that cannot be analyzed by the conventional scoring method.

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