摘要目的:探讨利用碲锌镉（CZT） SPECT进行 99Tc m-甲氧基异丁基异腈（MIBI）/ 123I-间碘苄胍（MIBG）双核素双动态心脏显像，完成定量分析的可行性。 方法:对2021年10月至2023年6月于中国医学科学院阜外医院治疗的24例心功能不全患者进行前瞻性研究，其中男性14例、女性10例，年龄（49.2±16.8）岁。所有患者均于第1日先行 99Tc m-MIBI单核素动态SPECT心脏显像；第2日行 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像，并进行完整物理校正和非完整物理校正。比较 99Tc m-MIBI单核素动态SPECT心脏显像与 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像计算获得的整体左心室（LV）和冠状动脉左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）支配区域心肌血流量（MBF）的差异，以及两种显像方法的相关性和一致性。采用Wilcoxon秩和检验比较 99Tc m-MIBI单核素动态SPECT心脏显像与 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像获得的LV和LAD、LCX、RCA支配区域MBF的差异。采用Pearson相关性分析及Bland-Altman法分析两种显像方法得到的MBF的相关性和一致性。 结果:99Tc m-MIBI单核素动态SPECT心脏显像与进行完整物理校正的 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像计算获得的LV的MBF分别为0.74（0.64，0.79）ml·min -1·g -1和0.74（0.64，0.80）ml·min -1·g -1，LAD支配区域的MBF分别为0.72（0.68，0.82）ml·min -1·g -1和0.74（0.64，0.84）ml·min -1·g -1，LCX支配区域的MBF分别为0.73（0.66，0.80）ml·min -1·g -1和0.74（0.61，0.79）ml·min -1·g -1，RCA支配区域的MBF分别为0.77（0.64，0.82）ml·min -1·g -1和0.77（0.66，0.82）ml·min -1·g -1。两者LV和LAD、LCX、RCA支配区域MBF的差异均无统计学意义（ Z=-1.349、-0.396、-0.350、-1.126，均 P>0.05）。 99Tc m-MIBI单核素动态SPECT心脏显像与进行完整物理校正的 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像获得的LV和LAD、LCX、RCA支配区域的MBF均有较好的相关性（ r=0.857、0.832、0.708、0.815，均 P<0.001）。 99Tc m-MIBI单核素动态SPECT心脏显像与进行完整物理校正的 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像计算获得的LV和LAD、LCX、RCA支配区域的MBF的平均差值为0.023、0.016、0.008、0.040 ml·min -1·g -1，95% CI分别为-0.125~0.170、-0.196~0.228、-0.181~0.196、-0.193~0.271，两者的一致性较好。 结论:利用CZT SPECT行 99Tc m-MIBI/ 123I-MIBG双核素双动态SPECT心脏显像，在经过完整物理校正后，能够得到与 99Tc m-MIBI单核素动态SPECT显像较为一致的MBF，通过一次检查完成MBF和心脏交感神经的定量分析是可行的。

abstractsObjective:To explore the feasibility of quantitative analysis in 99Tc m-methoxyisobutylisonitrile (MIBI)/ 123I-metaiodobenzylguanidine (MIBG) dual-isotope and dual-dynamic cardiac imaging using cadmium zinc telluride (CZT) SPECT. Methods:Twenty-four patients (14 males and 10 females) aged (49.2±16.8) years with cardiac dysfunction were prospectively enrolled from October 2021 to June 2023 at Fuwai Hospital, Chinese Academy of Medical Sciences. All the patients underwent 99Tc m-MIBI single-isotope dynamic cardiac imaging (referred to as single-isotope imaging) on the first day and 99Tc m-MIBI/ 123I-MIBG dual-isotope dual-dynamic cardiac imaging (referred to as dual-isotope imaging) on the second day. And complete physical correction and incomplete-physical correction were performed. Myocardial blood flow (MBF) for left ventricle (LV), left anterior descending branch (LAD), left circumflex branch (LCX), and right coronary artery (RCA) dominant area was quantified. Differences, correlation, and agreement of these parameters from two imaging methods were analyzed using Wilcoxon rank sum test, Pearson correlation test, and Bland-Altman analysis. Results:The MBF of LV and LAD, LCX, RCA dominant area of single-isotope imaging and dual-isotope imaging with complete physical correction were 0.74 (0.64, 0.79) ml·min -1·g -1vs. 0.74 (0.64, 0.80) ml·min -1·g -1, 0.72 (0.68, 0.82) ml·min -1·g -1vs. 0.74 (0.64, 0.84) ml·min -1·g -1, 0.73 (0.66, 0.80) ml·min -1·g -1vs. 0.74 (0.61, 0.79) ml·min -1·g -1, and 0.77 (0.64, 0.82) ml·min -1·g -1vs. 0.77 (0.66, 0.82) ml·min -1·g -1, respectively. The differences were not statistically significant ( Z=-1.349,-0.396, -0.350, -1.126; all P>0.05). The MBF of LV and LAD, LCX, RCA dominant area between single-isotope imaging and dual-isotope imaging with complete physical correction showed good correlations ( r=0.857, 0.832, 0.708, 0.815; all P<0.001). The MBF mean differences of LV and LAD, LCX, RCA dominant area between single-isotope imaging and dual-isotope imaging with complete physical correction were 0.023, 0.016, 0.008, 0.040 ml·min -1·g -1, and the 95% confidence intervals were -0.125 to 0.170, -0.196 to 0.228, -0.181 to 0.196, and -0.193 to 0.271, respectively. The agreement between the two acquisition methods was good. Conclusions:CZT-SPECT can be used to obtain comparable MBF between single-isotope imaging and dual-isotope cardiac imaging on the basis of complete physical correction. It is feasible to conduct a quantitative analysis of MBF and cardiac sympathetic nervous system through a single examination.