Comparative assessment of left ventricular volume curves using echocardiography, gated radionuclide angiography, and contrast left ventriculography was done in 11 cases of valvular heart disease. The parameters obtained from the left ventricular volume curves are enddiastolic volume (EDV), endsystolic volume(ESV), stroke volume(SV), and ejection fraction(EF). The parameters obtained from derivative curves of the left ventricular volume curves are peak ejection rate(PER), peak filling rate(PFR), time to peak ejection rate(TTPER), and time to peak filling rate(TTPFR). All the parameters(EDV, ESV, SV, and EF) obtained from left ventricular volume curves using three methods relate significantly each to each. The shapes of the left ventricular volume curves obtained from three methods were similar to each other. Without significant differences, noninvasive methods can be applied for serial and repetitive left ventricular volume curve analysis.
Echocardiography* ; Gated Blood-Pool Imaging* ; Heart Valve Diseases ; Stroke

BACKGROUND: Automated border detection(ABD) is a new echocardiographic modality providing continuous on-line measurements of left ventricular(LV) cavitary ares, volume, and ejection fraction(EF) throughout the cardiac cycle. Previous study showed that LV volume and EF measurements with ABD system approximate manually traced LV volume and EF obtained with conventional 2-dimensional echocardiography. But further clinical validation needs a comparison of LV function between the ABD system and established methods. The purpose of this study is to compare EF, peak ejection rate(PER) and peak filling rate(PFR) between on-line ABD system and the gated cardiac blood pool scinitigraphy. METHOD: 27 patients with an apical 4 chamber view of LV in which at least 75% of the endocardium was clearly seen were selected for this study. They had a normal sinus rhythm and underwent echocardiographic study on the same day of or one day before gated cardiac blood pool scintigraphic study. The off-line estimation of LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view and EFoff was calculated. Also on that view the ABD system was turned on, and EFABD, PEABD, PEABD were calculated automatically from LV volume curve. They were compared with EFRI, PERRI, and PERRI obtained by the gated cardiac blood pool scintigraphy. RESULTS: 1) EFoff and EFABD were highly correlated with EFRI(r=0.78, 0.90 respectively : p<0.001). The mean difference between EFRI and EFoff was 4+/-9%, and the limits of agreement between EFRI and EFoff were -16~22%, EFoff were less than EFRI(p<0.05). The mean difference between EFRI and EFABD was 5+/-7%, and the limits of agreement between EFRI and EFoff were -9~+19%. EFABD was also less than EFRI(p<0.05). 2) PERABD and PERABD were highly correlated with PERRI and PERRI(r=0.74, 0.60, respectively ; p<0.001). The mean difference between PERRI and PERABD was -0.1+/-0.7EDV(enddiastolic volume)/sec, and the limits of agreement were -1.5~+1.3EDV/sec. PEABD was slightly greater than PERRI(p>0.05). The mean difference between PERRI and PEABD was -0.8+/-0.8EDV/sec, and the limits of agreement were -2.4~+0.8EDV/sec. PEABD were greater than PERRI(p<0.01). CONCLUSION: EF, PER, PER measurements by the ABD system and the gated cardiac blood pool scintigraphy have significant correlations. Thus ABD echocardiography is a useful method for assessement of LV function.
Echocardiography* ; Endocardium ; Gated Blood-Pool Imaging* ; Humans ; Ventricular Function, Left*

To evaluate the usefulness of continuous wave Doppler echocardiography in the quantitative assessment of aortic regurgitation, the aortic regurgitant flow velocity curves taken by continuous wave Doppler echocardiography were analyzed to develop indexes such as the peak velocity(PV), the deceleration slope(SLOPE) and the pressure half time(PHT) in 66 patients with aortic regurgitation. The Doppler indexes were compared with the aortic regurgitation fraction(RF) obtained from gated radionuclide ventriculography in 33 patients without other valvular regurgitation, and were also compared with angiographic grading of aortic regurgitation in 47 patients who under went aortic angiography. The results were as follows : 1) The deceleration slope and the pressure half time were correlated well with the regurgitation fraction measured by gated radionuclide ventriculography (r=0.68, -0.78). 2) The deceleration slope increased significantly with increasing angiographic grading (rade 1+vs.2+ ; 1.89+/-0.61m/sec vs.2.64+/-0.39, P<0.05, Grade 2+ vs.3+ ;2.64+/-0.39 vs. 4.37+/-1.35, P<0.01, but statistical singnificance was not found between Grade 3+ and 4+(4.73+/-1.35vs. 5.00+/-0.39, P<0.05). 3) The pressure half time decreased significantly with increasing angiographic grading (Grade 1+vs.2+ ; 0.61+/-0.16 sec vs. 0.49+/-0.08, p<0.05, Grade 2+ vs.3+ ; 0.49+/-0.08vs. 0.29+/-0.07, p<0.01), but statistical significance was not found between Grade 3+ and 4+ (0.29+/-0.07vs. 0.26+/-0.08, p>0.05), either. 4) The pressure half time was independent of aortic or mitral stenosis associated with aortic regurgitation. 5) The peak velocity had no significant relationshop with the regurgitation fraction by gated radionuclide ventriculography or angiographic grading by aortic angiography. 6) A PHT threshold of 400 msec separated mild (Grade 1+ and 2+)and severe (grade 3+ and 4+) aortic regurgitation with sensitivity of 88%, specificity of 96% and predictive value of 95%. Therefore continuous wave Doppler echocardiographic method of anlyzing aoritc regurgitant flow velocity curve seemed to be useful for the noninvasive assessment of the severity of aortic regurgitation.
Angiography ; Aortic Valve Insufficiency* ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Gated Blood-Pool Imaging ; Humans ; Mitral Valve Stenosis ; Sensitivity and Specificity

Left ventricular(LV) diastolic filling is abnormal at rest in many patients with coronary arery disease, even in the presence of normal resting LV systolic function. To determine the effects of improved myocardial perfusion on impaired LV diastolic filling and to detect the most sensitive parameter to assess LV diastolic function, gated radionuclide ventriculography were performed in 14 patients with coronary artery disease before and after successful percutaneous transluminal coronary angioplasty(PTCA). All patients had no previous myocardial infarction and no abnormal wall motion in gated radionuclide and contrast ventriculography. The following results were obtained; 1) There were no significant differences in the parameters of LV systolic function, such as peak ejection rate(PER, time to peak ejection rate(TPER), ejection fraction(EF) after successful PTCA. 2) Peak filling rate(PFR) and time to peak filling rate(TPFR), indexes of LV diastolic function, had no significant changes after successful PTCA. 3) The percent contribution of late diastolic filling to stroke volume(%LDF/SV) decreased from 26.5+/-6.8% to 19.1+/-6.6%(p<0.005 by paired t-test). These data suggest that in many patients with angina and normal LV systolic function, impaired global diastolic filling is a reversible manifestation of impaired coronary flow, and percent contribution of late diastolic filling to stroke volume(%LDF/SV) can be a sensitive parameter to evaluate impaired LV diastolic filling in coronary artery disease.
Angina Pectoris* ; Angioplasty, Balloon, Coronary* ; Coronary Artery Disease ; Gated Blood-Pool Imaging ; Humans ; Myocardial Infarction ; Perfusion ; Radionuclide Ventriculography ; Stroke

We report an extremely rare case of a diffuse hepatic hemangiomatosis without extrahepatic involvement in an adult. The imaging findings of this tumor were similar to those of a hepatic hemangioma and included contrast enhancement with a centripetal filling pattern of the entire hepatic tumor on the delayed phase of a dynamic CT and inhomogeneous diffuse uptake of the entire tumor on blood-pool images obtained five hours later on a 99mTc-labeled red blood cell scan. Despite its rarity, diffuse hepatic hemangiomatosis can be suggested in adult patients with diffusely involved hepatic tumors showing the radiological findings of a hepatic hemangioma.
Adult ; Female ; Gated Blood-Pool Imaging ; Hemangioma/*diagnosis/pathology/ultrasonography ; Humans ; Liver Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

In this paper are presented and recommended the researches of the left ventricle model and optimization arithmetic based on myocardial radionuclide tomographic images (SPECT and PET). We adopted the hemispheric-cylindrical myocardial model which was largely used in quantitative analysis of myocardium. Then we adopted the radionuclide maximum counts method in LV myocardium and used the Powell optimization arithmetic to fit the myocardial model. Comparing the result from the adopted method against that of the doctors' diagnosis, we found the rate of high relevancy being 83.2%.
Algorithms ; Gated Blood-Pool Imaging ; Heart Ventricles ; diagnostic imaging ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Models, Cardiovascular ; Myocardium ; Positron-Emission Tomography ; methods ; Tomography, Emission-Computed, Single-Photon ; methods

BACKGROUND: It is absolutely necessary to evaluate cardiac function at starting and during hemodialysis in patients with end stage renal disease. In this study, we tried to determinate the changes of cardiac function associated with hemodialysis. METHODS: Twenty patients with end stage renal disease were enrolled , who had been in hemodialysis program from February, 1997 to August, 1999 in Pusan National University Hospital. They were examined with echocardiography and gated blood pool scintigraphy at starting hemodialysis and after follow-up. The data were analyzed by paired T-test. RESULTS: The patients were 46.2+/-16.8 years old and male to female ratio was 8 : 12. The underlying diseases were diabetes mellitus(n=10), hypertension(7), glomerulonephritis (2) and others(1). The duration of symptoms associated with end stage renal dis- ease and underlying diseases was 3.4+/-2.6 years, and the duration of hemodialysis was 13.8+/-7.0 months. The LVEDID, LVESID and RVC decreased significantly (-6.10, -7.80 and -20.00%, respectively, p<0.05) with no significant changes for LAD, IVS, PWT and EF (p>0.05). In ten cases associated with diabetes, LVEDID decreased (-7.90%, p<0.05). In twelve cases associated with cardiac diseases, LVEDID and LVESID decreased (-8.60 and -10.50%, respectively, p<0.05). In four cases associated with diabetes without cardiac diseases, LAD decreased (-5.10%, p<0.05). And in four cases associated with cardiac diseases without diabetes, there were no significant changes in cardiac dimensions and EF. In seven cases associated with diabetes and cardiac diseases, LVEDID decreased (-10.50%, p<0.05). The EF on gated blood pool scintigraphy decreased (-0.9%, p<0.05) as a whole, while increased (5.90%, p<0.05) in the cases associated with diabetes and cardiac diseases. CONCLUSION: During the early hemodialysis stage of end stage renal disease, we found a change of concentric left ventricular hypertrophy and relatively preserved left ventricular function. Furthermore we can expect that adequate hemodialysis -with dry-weight as low as possible - may prevent progression to eccentric left ventricular hypertrophy and dilated cadiomyopathy.
Busan ; Echocardiography ; Female ; Follow-Up Studies ; Gated Blood-Pool Imaging ; Glomerulonephritis ; Heart Diseases ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic* ; Male ; Renal Dialysis* ; Ventricular Function, Left

This paper is aimed to investigate the influence of gated myocardial perfusion imaging (G-MPI) with 8- and 16-frame acquisition models on the assessment of left ventricular function. Patients prepared for stress and rest G-MPI were prospectively recruited from January 2010 to January 2011 in the Department of Nuclear Medicine of West China Hospital, Sichuan University. Two separate G-MPI studies, one with 8 and the other with 16 frames, were simultaneously acquired during a single gantry orbit using Concurrent Imaging technique. We calculated the left ventricular ejection fraction (EF) and volumes using the Auto Quant software. Forty-eight patients (29 men, 19 women; average age 51 +/- 16 years old) were finally analyzed. The differences in left ventricular EF between 8- and 16-frame were small: 3.27% (95% CI: 6.41%-0.12%) for post-stress and 3.13% (95% CI: 5.93%-0.32%) for rest. Both using 8 and 16 frames, there were significantly larger volumes and lower EF in patients with stress-induced ischemia than without. As for detecting left ventricular EF, 8-frame and 16-frame acquisition models should not be mutually alternated.
Adult ; Aged ; Female ; Gated Blood-Pool Imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; physiopathology ; Myocardial Ischemia ; diagnostic imaging ; physiopathology ; Myocardial Perfusion Imaging ; methods ; Radiopharmaceuticals ; Stroke Volume ; physiology ; Technetium Tc 99m Sestamibi ; Ventricular Function, Left ; physiology

Based on the half sphere-cylinder myocardial model, a quantitative calculating method of gated SPECT myocardial infraction of the left ventricular functional parameters is proposed. To overcome the shortage of the ellipse model and other normal methods, this method uses the half sphere-cylinder myocardial model and its subarea. The experiment result shows that the data from normal men accord very well with those reported in domestic and international literature. The result from use in the case of left ventricular myocardial infarction is also satisfactory. Therefore, this method is of high value clinically.
Coronary Artery Disease ; diagnostic imaging ; physiopathology ; Gated Blood-Pool Imaging ; methods ; Heart Ventricles ; diagnostic imaging ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Models, Cardiovascular ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon ; methods ; Ventricular Function, Left

To evaluate left ventricular diastolic function in patients with coronary artery disease, gate radionuclide ventriculography was performed prospectively in 42 patients who were admitted to Seoul National University Hospital from November 1985 to August 1986 because of anterior chest pain. All patients had no valvular heart disease, congenital heart disease, cardiomyopathy and arrhythmia, and no abnormal vall motion in gated nuclide ventriculography and contrast left ventriculography. 25 patients with more than 50% of stenosis in coronary arteriography were compared with 17 control subjects without stenosis. The following results were obtained; 1) There were no significant differences between normal controls and patients with coronary artery disease in the analysis of the parameters of the left ventricular systolic function, such as ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER) and ejection time (TES, TES/BCL). 2) Same results were found with those of the left vnetricular diastolic function, such as peak filling rate (PFR), diastolic time interval (DTI, DTI/BCL), rapid diastolic filling interval and time to late diastolic filling (TLDF). 3) The percent contribution of late diastolic filling to stroke volume (%LDF/SV) was more increased in patients with coronary artery disease than the normal control subjects (38.2+/-12.4% vs 28.3+/-7.8%, P<0.01). 4) As the results of above, it can be concluded that the percent contribution of late diastolic filling to stroke volume (%LDF/SV) obtained by using the non-invasive method of gated radionuclide ventriculography can be a sensitive parameter for early evaluation of the left ventricular diastolic dysfunction in coronary artery disease.
Angiography ; Arrhythmias, Cardiac ; Cardiomyopathies ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Gated Blood-Pool Imaging ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Prospective Studies ; Radionuclide Ventriculography ; Seoul ; Stroke Volume