Japanese
Title核医学的, 心筋表面Mappingによるischemic myocardiumの部位決定
Subtitle原著
Authors藤原靖之*, 村上和彦*, 百目木公一*, 友成正紀*, 春日信照*, 小林武彦*, 尾形直三郎*, 石井定美*, 堀口泰良*, 古川欽一*, 高橋雅俊*, 東与光**
Authors(kana)
Organization*東京医科大学・外科, **神奈川歯科大学・放射線科
Journal核医学
Volume14
Number1
Page33-39
Year/Month1977/2
Article原著
Publisher日本核医学会
Abstract「I. はじめに」虚血性心疾患に対する外科療法が盛んに行われている折から, 急性心筋硬塞に対しても緊急手術として積極的に手術を試みようとされている現状である. これには虚血部位の正確な把握が大切であることは論をまたない. 近年, アイソトープを利用しての虚血性心疾患の診断はめざましい発展をとげてきている. 特に有用な核種の開発, シンチスキヤナー, シンチカメラの改良にともない安全で容易に行いうる診断方法になってきている. しかし, 体外よりの心筋スキヤンニング法, あるいはシンチカメラ法では, ある程度までの心筋虚血部位の判定はできるが, 正確な範囲を決定するまでには至らない. われわれは, この虚血性心疾患の術中に直接に心筋表面よりアイソトープを測定する事により, 心筋虚血部位の範囲を正確に判定する方法, また, 術後の心筋への血液供給状態の改善度を判定する方法について種々実験を行っている.
Practice臨床医学：一般
Keywords
English
TitleDetermination of Ischemic Myocardium by Surface Mapping Method Using the Semiconductor Detector
SubtitleOriginal Articles
AuthorsYasuyuki FUJIWARA, Kazuhiko MURAKAMI, Kinichi DOMEKI, Masaki TOMONARI, Nobuteru KASUGA, Takehiko KOBAYASHI, Naosaburo OGATA, Sadayoshi ISHII, Yasuyoshi HORIGUCHI, Kinichi FURUKAWA, Masatoshi TAKAHASHI1), Tomomitsu HIGASHI2)
Authors(kana)
Organization1)Dept. of Surgery Tokyo Medical College, 2)Dept. of Radiology, Kanagawa Dental College
JournalThe Japanese Journal of nuclear medicine
Volume14
Number1
Page33-39
Year/Month1977/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractThis study was disigned to determine the extent and the size of ischemic myocardium produced by occlusion of a left descending coronry artery(LAD)experimentally. Under the general anesthesia with sodium penthobarbital intravenously, ischemic myocardium was produced in 10 dogs surgically, then Iodine-131 Macroaggregated Albumin(131I-MAA, 100μCi)was injected in the both right and left cornonary arteries through a baloon catheter fifteen minutes after occlusion of the LAD. In order to define the areas of ischemic myocardium, the radioactivity was evaluated by a catheter type p-i-n semiconductor detector(Mitsubishi RI catheter)at 9 to 12 sites on the anterior surface of the left ventricle. The actual radioactivity from the myocardial surface was 331-437 cpm, 370+-42 cpm at the nonischemic areas, 96-176 cpm, 130+-26 cpm at the ischemic areas. The radioactive counting ratio in the ischemic areas was 35.09+-7.2%(p<0.002)of the nonischemic areas(100%). Also, myocardial surface pH and ST segment elevation of epicardial ECG were measured from the myocardial surface at the same sites. The myocardial surface pH in nonischemic area was 8.05+-0.27in average. In the ischemic areas 15min after occlusion of LAD, average surface pH fell to 7.58+-0.25(p<0.01). The average hight of the ST segment of ischemic areas 15min after occlusion of LAD raised 6.05+-2.28mV higher than nonischemic areas. There was a reasonable coefficient of correlation among radioactivity and pH of the myocardial surface and elevation of ST segment. We concluded that the extent and the size of the area of ischemic myocardium may be dfined by mapping of surface radioactivity during surgery for acute myocardial ischemia.
PracticeClinical medicine
Keywords

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