| Objective The aim of the study was to evaluate left ventricular function in Graves' disease patients with before and after 131I treatment by 99Tcm-MIBI rest gated myocardial perfusion imaging (GMPI).Methods Twenty-seven Graves' disease patients(onset for the first time, without any anti-thyroid drug therapy, preparation for 131I treatment), were studied by rest gated myocardial perfusion imaging in the first hospital of Shan xi medical university between June and November 2007. There were seven cases of male and twenty cases of female, with an average age of 39.04±7.77(2458)years, with an average duration of 7.30±7.85(124)months. The imaging was performed before the 131I treatment and three months after the 131I treatment. Acquisition protocol: 99Tcm–MIBI, a dose of 740925MBq(2025mCi), ulnar injection, 12hr and SPECT images. Image acquisition was performed with a double-head SPECT(VERTEX, made in the company of America) which was using low-energy high-resolution collimator.①More than two experienced nuclear medicine physicians evaluated the cardiac perfusion results by the qualitative analysis of 9-segment.②The cardiac function parameters were processed automatically by the QGS software, including end-diastolic volume(EDV), end-systolic volume(ESV) and left ventricular ejection fraction(LVEF). Stroke volume(SV) was calculated by EDV-ESV. Heart rate(HR) was recorded from the ECG Monitor. To acquisition the image of the original demarcation of the lung and heart regions of interest(ROI), and then the lung-heart ratio(LHR) was calculated by left lung ROI average pixel counts/myocardium ROI average pixel counts.③On the basis of a 17-segment model of the left ventricle, the quantitative analysis of the following indexes by the procedure was observed. GSPECT consisted of left ventricular wall segment motion and thickening. Using statistical methods, we studied the changes of quantitative indicators before and after 131I treatment.Results①Before 131I treatment, the distribution of agents was decreased in anterior wall of five patients and in anterior and inferoposterior wall of one patient. After 131I treatment, the perfusion imagings of five patients were normal except one.②HR, EDV, ESV and LHR were decreased significantly(103.93±14.06vs.77.15±7.96, 86.15±22.95vs.79.19±16.50, 33.63±12.98 vs.31.00±11.29, 0.38±0.04vs0.35±0.03, P<0.05). There weren't statistically significant in LVEF and SV(61.56±8.91vs.64.41±6.27, 52.52±13.75vs.48.19±8.41, P>0.05).③After the 131I treatment, The motion of the basal anterolateral, mid inferolateral, mid anterolateral, apical inferior, apical lateral and apex was significantly low(P<0.05). The motion of the basal anterior septal and mid anterior septal was significantly strong(P<0.05). The thickening of basal inferoseptal, mid inferior, apical inferior and apex was decreased significantly(P<0.05). There weren't statistically significant in other segments(P>0.05).Conclusions The left ventricular function in Graves' disease patients have definitely changed after three months 131I treatment.①The myocardium segmental perfusion was decreased in Graves' disease patients. After three months 131I treatment, the vast majority returned to normal.②After three months 131I treatment, HR, EDV and ESV were decreased significantly. LVEF and SV weren't statistically significant.③After three months 131I treatment, the pulmonary uptaking 99Tcm-MIBI was decreased significantly, resulting in LHR reduction and cadiocyte function improvement.④Because of the high-power status in Graves' disease patients, the myocardial contractility was increased, the wall motion and wall thickening rate of several left ventricular segments were decreased with 131I treatment after three months. |
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