. 2006; 21(4): 170-173 | |||
The relation between the change of the electrical axis of heart during inspiration and diaphragmatic attenuation artifact in myocardial perfusion scintigraphyHurşit Soyer1, Bahadır Ceylan2, İlhami Uslu31Hayrünnisa Hospital, Cardiology, Istanbul2Istanbul Education and Research Hospital, Department of Clinical Microbiology and Infectious Diseases, Istanbul 3Istanbul University Faculty of Medicine, Department of Nuclear Medicine, Istanbul Diaphragmatic attenuation artifact (DAA) is the most frequent artifact related to the inferior wall of left ventricle during the myocardial perfusion (MP)-SPECT imaging of male patients. Several standard methods are used to avoid DAA, however all have certain limitations. Imaging in prone position is among the most common methods, although some individuals experience difficulty in lying at this position. We examined the effectiveness of change in the mean electrical axis of heart, on the identification of DAA. It is a parameter believed to reflect the position of the heart within thorax and its relation with the diaphragm, particularly during respiration. A total of 67 patients were included in the study. Waist/hip ratio, body mass index were recorded for all patients. ECG's during normal respiration and deep inspiration were obtained and mean electrical axis was calculated. Routine MP-SPECT imaging, imaging at prone position and gated SPECT study were performed. Patients were evaluated after allocation to either DAA (+) or DAA (-) groups. Mean changes in axis were 13.8±16.2 and 45.8±31.2 degrees for DAA (+) and DAA (-) groups, respectively, with a statistically significant difference (p>0.05). Results of ROC analysis found that 17 degrees or less axis change might be indicative of DAA diagnosis. In conclusion, a 17 degrees or less change in the mean electrical axis of the İnspiryumda kalbin elektriksel eksenindeki değişiklik derecesi ile miyokard perfüzyon sintigrafisindeki diyafragmatik atenüasyon artefaktı arasındaki ilişkiHurşit Soyer1, Bahadır Ceylan2, İlhami Uslu31Hayrünnisa Hastanesi, Kardiyoloji Kliniği, İstanbul2İstanbul Eğitim ve Araştırma Hastanesi, Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kliniği, İstanbul 3İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, İstanbul Diyafragmatik atenüasyon artefaktı (DAA), miyokard perfüzyon-SPECT (MP-SPECT) görüntülemesinde, erkeklerde sol ventrikülün inferiyor duvarına ilişkili olarak en sık karşılaşılan atenüasyon artefaktıdır. DAA’nın giderilmesi için bazı standart yöntemler uygulanmaktadır. Ancak, bu yöntemlerin bazı kısıtlılıkları mevcuttur. Pron pozisyonunda görüntüleme en yaygın uygulamalardan biri olmakla birlikte, bazı hastalar bu pozisyonda yatma zorluğu çekmektedirler Bizim çalışmamızda kalbin toraks içindeki pozisyonunu ve özellikle solunum sırasında diyafragma ile ilişkisini yansıttığı düşünülen inspiryumda Hurşit Soyer, Bahadır Ceylan, İlhami Uslu. The relation between the change of the electrical axis of heart during inspiration and diaphragmatic attenuation artifact in myocardial perfusion scintigraphy. . 2006; 21(4): 170-173 Corresponding Author: Hurşit Soyer, Türkiye |
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