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Nuklearmedizin 1999; 38(06): 178-185
DOI: 10.1055/s-0038-1632215
Originaler Artikel
Schattauer GmbH

Influence of Patient Position in Myocardial SPECT on the Diagnosis of CHD

Einfluß der Patientenlagerung bei der Myokard-SPECT auf die Diagnose einer KHK
P. Reuland
1   Praxis für Nuklearmedizin, Freiburg, Germany
2   Department of Nuclear Medicine, University of Tübingen, Germany
,
M. Irmer
3   Medical Clinic, University of Freiburg, Germany
4   Praxis für Kardiologie, Freiburg, Germany
,
T. Stiehr
1   Praxis für Nuklearmedizin, Freiburg, Germany
,
Aneke Schroff
1   Praxis für Nuklearmedizin, Freiburg, Germany
,
Andrea Heinzel
1   Praxis für Nuklearmedizin, Freiburg, Germany
,
H. H. Weyer
1   Praxis für Nuklearmedizin, Freiburg, Germany
› Author Affiliations
Further Information

Publication History

Received: 15 September 1998

in revised form: 08 January 1999

Publication Date:
02 February 2018 (online)

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Summary

Aim of the study was to show that changing patient position from supine to prone results in improved specificity of myocardial SPECT (MS). Methods: We examined the influence of patient position in MS on the diagnosis of coronary heart disease (CHD) in 151 patients. By using a Tc-99m-labeled compound (Tetrofosmin, Myoview™, Nycomed, Amersham) examinations could be performed in supine and prone position within 35 minutes. Examinations were performed as a two-day stressrest protocol with one gamma camera head and 180° rotation without absorption correction. Results: Semi-quantitative patient and heart phantom data show similar values for anterior and inferior wall in prone position in contrast to a lower count ratio of inferior to anterior wall in supine position. This demonstrates the importance of patient position with respect to artifacts specificity. Changing patient position from supine to prone mainly improves diagnostic specificity for CHD in the inferior wall in men (from 58% to 90%) and in the anterior wall in women (from 80% to 93%). Sensitivity is the same for both techniques. Conclusion: Changing patient position from supine to prone significantly improves diagnostic specificity while sensitivity remains unchanged.

Zusammenfassung

Ziel der Studie war es zu zeigen, daß die Änderung der Patientenposition von der Rückenlage in die Bauchlage die Spezifität der Myokard-SPECT (MS) verbessert. Methode: Wir haben den Einfluß der Patientenlagerung auf die Diagnosestellung einer KHK bei 151 Patienten untersucht. Durch Verwendung einer Tc-99m-Verbindung (Myoview™, Nycomed, Amersham) konnten die Aufnahmen in Rücken- und Bauchlage innerhalb von 35 Minuten durchgeführt werden. Die Untersuchungen wurden als 2-Tage-Belastungs-Ruhe-Protokoll durchgeführt mit einem Gammakamerakopf über 180° ohne Schwächungskorrektur. Ergebnisse: Semiquantitative Patienten- und Phantomdaten zeigen in Bauchlage im Gegensatz zu den Aufnahmen in Rückenlage ähnliche Werte für die Vorder- und Hinterwand, während in Rückenlage die Countraten im Bereich der Hinterwand niedriger als in der Vorderwand sind. Dies belegt die Bedeutung der Patientenlagerung für die Spezifität im Hinblick auf Artefakte. Die Änderung der Patientenposition in die Bauchlage verbessert vor allem die Spezifität für die Diagnose einer KHK im Bereich der Hinterwand bei Männern (von 58% auf 90%) sowie im Bereich der Vorderwand bei Frauen (von 80% auf 93%). Die Sensitivität ist für beide Verfahren gleich hoch. Schlußfolgerung: Durch Änderung der Patientenposition von der Rückenlage in die Bauchlage läßt sich die diagnostische Spezifität für die Diagnose einer KHK deutlich steigern, ohne daß die Sensitivität sich verändert.

Key words

Myocardial SPECT - patient positioning - CHD - artifacts

Schlüsselwörter

Myokard-SPECT - Patientenlagerung - KHK - Artefakte
 

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