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Evaluation of the SPECT radioisotope perfusion scan in the detection of ischemic heart disease

Zdanowski Paweł, Cacko Marek, Rabczenko Daniel, Kochman Janusz, Królicki Leszek

Inżynier i Fizyk Medyczny

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2022

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Vol. 11, nr 2

129--135

EN

Objectives: The aim of the study is to determine the diagnostic value of myocardial perfusion scintigraphy (MPS) depending on the location and size of stenosis of a coronary vessel or vessels. Methods: Results of examinations of patients hospitalized in two hospital departments of the same medical facility were analyzed. Retrospective research material consisted of results obtained for 200 patients with suspected ischemic heart disease (coronary artery disease - CAD). From this group, 83 examinations were selected where results of coronary angiography and perfusion scintigraphy (MPS) were available. The following tests were used for statistical studies: t-Student, Chi2, Fisher- -Sendecor, Kruskal-Wallis and Willcoxon. The use of these tests allowed for: – determination of predictive factors favoring development of ischemic heart disease in the analyzed group of patients, – determination of sensitivity and specificity of MPS, taking the coronary examination as the “gold standard”, – assessment of usefulness of the MPS imaging depending on location of a stenosis within the main coronary vessels, – evaluation of usefulness of MPS in detection of a multivessel disease. Results: I n t he a nalyzed g roup o f p atients, a rterial h ypertension was the main factor predisposing to CAD (p = 0.016). The highest sensitivity of MPS in the diagnosis of ischemia was found in the group of patients with stenosis of the right coronary artery (RCA) (p = 0.029) and the circumflex (Cx) and marginal (MB) branches (p = 0.028). A comparative analysis was performed between the degree of narrowing of the above vessels and the degree of perfusion disorders in the MPS study. There was a correlation between the severity of ischemia in MPS and the degree of stenosis in both RCA (p = 0.011, 95% sensitivity (83.1 - 99.4 CI; negative predictive value 83.3%) and the Cx/MB complex (p = 0.044, sensitivity 94.7% ( 83.1 - 99.4 CI), negative predictive value - 83.3%). There was a correlation between the result of the MPS perfusion scan and disease of two or three coronary vessels. There was a 97% agreement between the presence of permanent or transient defects in MPS and the presence of stenosis in 2 or 3 coronary vessels exceeding 80% of the vessel lumen. In the group of patients with stenosis ranging between 50-80%, abnormal results of the MPS occurred in 41.7% of patients. Conclusion: The results confirm that myocardial perfusion scintigraphy is a very valuable screening test in patients with suspected CAD. This examination shows high sensitivity also in the group of patients with multivessel disease.

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Metody i urządzenia do diagnostyki serca

Pałko T.

Inżynier i Fizyk Medyczny

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2013

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Vol. 2, nr 4

169--174

PL

W artykule opisano główne choroby serca i naczyń krwionośnych oraz nowoczesne techniki ich badania. Przedstawiono elektrokardiografię, polifizjografię, metody pomiaru ciśnienia krwi, techniki obrazowania struktur i czynności serca i naczyń, w tym rentgenografię, echoultrasonografię, techniki scyntygrafii radioizotopowej oraz tomografii komputerowej (XCT, MRI, SPECT, PET, tomografie multimodalne). Przedstawiono wnioski i wskazano na potrzebę wzajemnej współpracy lekarzy, fizyków i inżynierów medycznych dla dalszego efektywnego rozwoju metod i technik diagnozowania chorób układu krążenia.

EN

In the paper the main heart and vessel diseases were described, as well as modern technologies of their examination. There were presented techniques such as: electrocardiography, polyphysiography, blood pressure measurement methods, heart and vessel structure and activity imaging methods. Particularly, the X-ray radiography, echoultrasonography and several methods of computed tomography (XCT, MRI, SPECT, PET, multimodal tomography), were described. It was indicated that close cooperation between medical doctors, medical physicists and engineers is needed for progress in diagnostic methods in cardiology and medicine.

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Zastosowanie analizy tekstury obrazu do oceny dynamiki prawidłowego przepływu wieńcowego w badaniu koronarograficznym

Syrycki M., Mazurek W.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2008

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Vol. 14, nr 3

242-244

PL

W pracy przedstawiono wstępne rezultaty przeprowadzonej próby oszacowania prawidłowego przepływu wieńcowego w oparciu o cyfrową analizę sekwencji standardowych obrazów koronarograficznych naczyń wieńcowych o różnej średnicy. Zastosowano rozszerzony pakiet analizy tekstury w postaci programu MaZdaŽ. Dokonano wyboru najważniejszych parametrów tekstury przydatnych do realizacji założonego zadania. Uzyskano wyniki wskazujące na dużą czułość opracowywanej metody.

EN

The paper presents preliminary results of the normal coronary blood flow estimation by means of texture analysis of the standard coronarography scans. The coronary vessels with the various size were examined. The software MaZdaŽ for texture analysis was used. The most significant parameters of the texture, useful for coronary blood flow estimation, were determined and analyzed. The results of performed analysis indicate the high sensitivity of this method.