Japanese
Title201Tl心筋シンチグラフィーによる左室壁肥厚の診断
Subtitle原著
Authors本原征一郎*, 玉井秀男*, 尾藤慶三*, 上畠拓*, 田巻俊一*, 芹生陽一*, 丹保幸広**, 米倉義晴***, 石井靖***, 鳥塚莞爾***
Authors(kana)
Organization*滋賀県立成人病センター内科, **滋賀県立成人病センター放射線部, ***京都大学医学部放射線核医学科
Journal核医学
Volume15
Number5
Page697-711
Year/Month1978/8
Article原著
Publisher日本核医学会
Abstract「要旨」左室心筋肥厚の診断を目的として, single bolus injection後の201Tlの心腔内通過過程, および心筋への集積の動態を, computerized multicrystal gamma cameraを用いて左前斜位35度にて収録し, 以下の処理を行なった. (1) 初回循環時の右室および左室内腔像を合成し, 両室間にある心室中隔を陰性像として造影する. (2) 左室内腔像を引き算した左室心筋像を陽性像として造影する. (3) indicator fractionation principleを用いて, 心筋血流量 / 心拍出量比を, 全左室心筋, 中隔部, 心尖部, 自由壁部別に得る. 正常5例, 高血圧症による左室肥大7例, 肥大型心筋症6例について検討し, これら三法を用いて左室肥大の診断が可能なことを示した. とくに, 非対称性肥大型心筋症における肥大の局所差の検出には有益な方法であり, 心室中隔下部から心尖部にかけての肥厚の診断については, 超音波法の盲点を補いうる.
Practice臨床医学：一般
Keywords201Tl scintigraphy, computer processing, left ventricular hypertrophy, hypertrophic cardiomyopathy, myocardial blood flow.
English
TitleDiagnosis of Left Ventricular Hypertrophy by 201Tl-myocardial scintigraphy
SubtitleOriginal Articles
AuthorsSeiichiro MOTOHARA*, Hideo TAMAI*, Keizo BITO*, Hiromu UEHATA*, Yoichi SERIU*, Shunichi TAMAKI*, Yukihiro TAMPO*, Yoshiharu YONEKURA**, Yasushi ISHII**, Kanji TORIZUKA**
Authors(kana)
Organization*Shiga Prefectural Medical Center for Adult Diseases, **Department of Radiology and Nuclear Medicine, Kyoto University
JournalThe Japanese Journal of nuclear medicine
Volume15
Number5
Page697-711
Year/Month1978/8
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] A new approach to the diagnosis of diffuse and localized left ventricular hypertrophy (LVH) was made with the isotopic imaging technic. Five normal subjects, seven patients with LVH caused by hypertension and six patients with idiopathic hypertrophic cardiomyopathy (HCM) were studied. A computerized multicrystal gamma camera (System-77, Baired-Atomic Co.) was used. The detector was set to the 35 degrees left anterior oblique position and a bolus injection of 201Tl (2-4 mCi) was made via the antecubital vein. The transportation process of the tracer in the cardiac chambers and its accumulation process in the myocardium were recorded in 800 serial frames over 240 seconds (0.3 sec/frame) and stored in the disc memory of the computer. The data were played back and processed as follows : (1) Images of both the right and left ventricular cavities were made by adding the appropriate frames. By double-exposure of the two images both ventricles were synthetized on film by which the interventricular septum (IVS) was visualized as a negative portion between the ventricles. (2) The image of the left ventricular cavity was subtracted from a myocardial scintigram by the computer. This processing clarified the inner border of the left ventricular wall and ventricular wall thickness was visualized as a positive image. (3) Myocardial blood flow (MBF) in the total left ventricle, apical, septal and free-wall portions were measured by application of the indicator fractionation principle. The positive image of the ventricular wall was useful in the diagnosis of LVH, especially when the LVH was localized. In HCM, one patient showed localized hypertrophy at IVS, three at the apical portion and one mainly at the free wall. The negative image of IVS was useful in patients with septal hypertrophy, as in asymmetrical septal hypertrophy or diffuse LVH. Total left ventricular MBF was 2.48 +- 0.32% of cardiac output in normal, 4.91 +- 1.83% in hypertension and 4.68 +- 1.60% in HCM patients. MBF was increased at the site of localized hypertrophy.
PracticeClinical medicine
Keywords201Tl scintigraphy, computer processing, left ventricular hypertrophy, hypertrophic cardiomyopathy, myocardial blood flow.

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