spect-ct临床优势PPT.pptx

SPECT/CT临床优势解放军307医院核医学科丁勇2014-3-22SPECT/CT?包含SPECT和CT两种仪器，可分别进行SPECT和CT成像，成像范围为全身或局部一体化，病人不移动位置，两种图像可以精确融合CT图像用作对SPECT图像的衰减校正SPECT/CT的优势骨及肿瘤显像：定位更精确确诊断更准确心脏：更快速更准确（衰减校正）SPECT/CT的优势甲状腺质量估算更准确肾脏GFR计算（深度校正）更准确治疗评价更全面介入治疗病灶数1252843100475恶性病灶52无法定论良性病灶507725440SPECTSPECT?CT一体化诊断级SPECT/CT，提高诊断准确率SPECT 与 SPECT?CT 在对肿瘤病灶诊断准确性的比较?有了SPECTCT后，90% 以上的患者的有了明确的诊断 Wolfgang R?mer, MD, University Clinic of Nuclear Medicine, Erlangen, Germany心脏IQ?SPECT采集及后处理IQ?SPECTIQ?SPECT专用准直器IQ?SPECT追心采集IQ?SPECT特殊后重建SMARTZOOM Collimator4 x more counts from the heartNo truncationCardio-centric orbitHeart is always in the maximum zoom areaHeart is the center of rotationData driven Collimator response for 48.000 uniquely positioned holesShort reconstruction timesThe information about IQ?SPECT is preliminary. The product is under development, not commercially available in the U.S., and its future availability cannot be ensured.4分钟门控心肌采集，1分钟衰减校正和钙化积分(IQ.SPECT，4倍采集速度)18-minLEHR (CTAC)4-minIQ?SPECT (CTAC)Stress CTAC LEHR 18 minutes Stress CTAC IQ?SPECT 4 minutesStress CTAC LEHR 18 minutes Stress CTAC IQ?SPECT 4 minutesStress CTAC LEHR 18 minutes with integrated CT calcium scoringStress CTAC IQ?SPECT 4 minutesData courtesy of the University of Michigan, Ann Arbor, Michigan, USAStudy protocol: Symbia T16; 20mCi 99mTc-Sestamibi stress injection; IQ?SPECT stress study: 17 frames, 9 seconds per frame (Total scan time: 4 minutes ); LEHR stress study: 32 frames, 32 seconds per frame (Total scan time: 18.3 minutes) SPECT/CT临床应用冠心病的诊断 患者，女性，近期偶感胸痛- SPECT心肌灌注下壁灌注缺失- 经 CT衰减校正，灌注正常 SPECT/CT 纠正膈肌、女性乳房对心肌灌注显像的影响，减少假阳性的发生 未衰减校正图2衰减校正f图1a机型Symbia T2gbSPECT\CT断层显像：患者静脉注射99Tc-MIBI 20mCi后1.5小时显像双探头采集，探头模式为90度夹角探头旋转角度为180度，每探头采集32帧图像每帧采集20s放大倍数1.45矩阵为128*128 采用Flash3D重建非门控图像：迭代次数：4；子集：8；高斯平滑：8 FWHM门控图像：迭代次数：4；子集：15；高斯平滑：8FWHM准直器：低能高分辨平行孔准直器CT：130Kv，CareDose 4D准直：2X2.5mm重建层厚：5mmeijdhc 图1：未衰减校正SPECT心肌灌注水平长轴切面图（a）示左室下壁灌注明显减低（箭头）、垂直长轴切面图（b）示左室前侧壁中段和基底段灌注明显减低（箭头）。黑障灌注靶心