Japanese
Titleシンチグラムによる非観血的心筋局所灌流異常の診断
Subtitle原著
Authors成田充啓*, 宇佐美暢久*, 栗原正*, 瓦谷仁志*, 本田稔**, 小川正**, 金尾啓祐**
Authors(kana)
Organization*住友病院 内科, **住友病院アイソトープ室
Journal核医学
Volume15
Number1
Page57-67
Year/Month1978/2
Article原著
Publisher日本核医学会
Abstract「緒言」近年における核医学的手技の発展は, 虚血性心疾患の評価や研究における種々のアプローチを可能としつつある. とりわけK同族体である201Tl, 81Rbの導入は, これらのRIが, 静注後, 速やかに, その局所灌流状態に応じて, 機能心筋内に分布することにより, 単に心硬塞壊死部を明示するのみでなく, 一過性に生じた心筋虚血の診断をも可能とすることが示唆されてきた. われわれは, 201Tl, 81Rbを用いて, 非観血的に心筋の局所灌流異常の診断を行なうことを目的とし, 次のごとき研究を行なった. 1) 心筋ファントムを作成し, シンチグラム上に表現しうる心筋壊死部の大きさの実験的検討. 2) 健常例, 虚血性心疾患を対象とした, 安静時および運動負荷時における心筋シンチグラム. このシンチグラムと心電図所見, 一部の症例では冠動脈造影所見と対比すること. 3) 心筋硬塞群では, 99mTc-HSA (人血清アルブミン) によるRI心血管造影から, 左室駆出率, 左室不共同収縮 (asynergy) を求め, これらと心筋シンチグラムでみた低灌流領域の広がりとの相関をみる. 以上の3項目である.
Practice臨床医学：一般
Keywords
English
TitleNonivasive detection of regional myocardial perfusion abnormality by scintigraphic technique
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Masahisa USAMI*, Tadashi KURIHARA*, Hitoshi KAWARADANI*, Minoru HONDA**, Tadashoi OGAWA**, Keisuke KANAO**
Authors(kana)
Organization*Department of Internal Medicine, Sumitomo Hospital, **Division of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume15
Number1
Page57-67
Year/Month1978/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] For the detection of regional myocardial perfusion abnormality noninvasively, myocardial scintigrams were obtained at rest and during exercise by using 201Tl or 81Rb. Myocardial imagings were performed using a scintillation camera (Pho/Gamma HP) equipped with either pararell-hole high resolution collimator (in case of Tl) or pinhole collimator and specially constructed lead shielding (in case of Rb) . Scintigrams were obtained in anterior, left anterior oblique and left lateral position. 1) Resting scintigrams in myocardial infarctions. Twenty patient of myocardial infarction were examined. All of them showed regional perfusion defect by scintigram, which locations coincided with the sites of infarction diagnosed by Ecg or coronary angiograms, and with asynergic zones obtained by Ecg synchronous RI-angiocardiograms. %-hypoperfusion (extent of cold area/total left ventricular area) correlated well with %-asynergy (r=0.85) and with left ventricular ejection fraction (r= -0.87) . 2) Exercise stress scintigram. For exercise studies, patients underwent graded ergometer exercise stress test under continuous Ecg monitoring. Patients exercised to the point of positive ST-change, anginal chest pain or 85% of predicted maximal heart rate, at which time tracer was administered intravenously. Exercise was continued additional one ninute. On the basis of ST-change of exercise Ecg, patients were divided into 3 groups : positive 7, equivocal 7 negative 15. Exercise induced hypoperfusion was detected in 14 patients (exercise Ecg positive 6, equivocal 5, negaive 2) . Effort angina was diangosed 83% by stress scintigram, but 58% by stress Ecg. Fingings of stress scintigram more coincided with coronary angiogram findings than stress Ecg. 3) Phantom study. The myocardial phantom was composed of two concentric glass beakers. The space between tow vessels simulated myocardium and was filled with 150μCi of Tl. Wax "lesions" of various size were placed in the space between the two vessels. To simulate background activity in the lung, water containing 200μCi of Tl was arranged around the cardiac phantom. Wax lesions above 2.5-3.0 cm were clealy detected.
PracticeClinical medicine
Keywords

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