Japanese
Title201Tl心筋摂取率測定による心筋血流の評価
Subtitle《原著》
Authors米倉義晴*, 石井靖*, 鳥塚莞爾*, 門田和紀**, 神原啓文**, 河合忠一**
Authors(kana)
Organization*京都大学医学部放射線核医学科, **第三内科
Journal核医学
Volume17
Number10
Page1211-1220
Year/Month1980/12
Article原著
Publisher日本核医学会
Abstract「要旨」201Tl心筋シンチグラムの定量化を目的として, その心筋摂取活性の投与量に対する比(心筋摂取率)を, 心筋血流/心拍出量比(MBF/CO)とみなして, このような定量化の臨床的意義を検討した. 安静時心筋摂取率は正常対照群(3.36±0.49%)よりも冠動脈疾患群(4.11±1.12%)では高値を示したが, これは心筋重量の増加によると推測された. 運動負荷により正常対照群では全例有意な増加(75±11%)を示したが, 冠動脈疾患群では増加率が低く, 特に近位部に50%以上の狭窄を有する群では有意な増加を認めず(11±21%), この増加率を指標とするsensitivityは, 負荷シンチグラムのそれよりすぐれたものであった. 正常対照群ではこの増加率と心仕事量の増加との間に対応した比例関係が認められるのに対し, 冠動脈疾患群では狭窄度の進行とともにこの比例関係がくずれており, その値は心筋酸素需要と血流供給との関係を示すものと考えられた.
Practice臨床医学：一般
Keywords201Tl myocardial scintigraphy, fractional myocardial uptake, myocardial blood flow, coronary artery disease, exercise loading
English
TitleQuantitative Assessment of Myocardial Blood Flow by Measurement of Fractional Myocardial Uptake of 201Tl
Subtitle- Original Articles -
AuthorsYoshiharu YONEKURA*, Yasushi ISHII*, Kanji TORIZUKA*, Kazunori KADOTA**, Hirofumi KAMBARA**, Chuichi KAWAI**
Authors(kana)
Organization*Department of Radiology and Nuclear Medicine, and **3rd Division, Department of Internal Medicine, Kyoto University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume17
Number10
Page1211-1220
Year/Month1980/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Fractional Myocardial uptake of 201Tl was measured for the quantitative assessment of myocardial blood flow in coronary artery disease (CAD). 10 normals and 28 CAD, 7 of which have less than 50% stenosis (CAD I) and 21 of which have more than 50% stenosis (CAD II) in the proximal portion of coronary arteries, were studied at rest and with submaximal exercise loading by bicycle ergometer. After intravenous injection of 201Tl, its rapid transport process was recorded during the initial 5 minutes by a scintillation camera and a minicomputer. Total injected dosage (T) was obtained from the counts of the entire chest region during the initial passage of the tracer through the heart and lung. Myocardial uptake (M) was counted with the same geometry from the subsequent accumulation within the myocardial region with subtraction of the background activities in the upper mediastinal region (B). The fractional myocardial uptake of 201Tl ((M-B)/T) is assumed to be proportional to the fractional myocardial blood flow to cardiac output (MBF/CO) according to the indicator fractionation principle. The average value of MBF/CO at rest in CAD (4.11 +- 1.12%) was significantly greater than in normals (3.36 +- 0.49%), which may be caused by an increased left ventricular mass in CAD. Change rate of MBF/CO on the exercise loading was significantly less in CAD I (1.36 +- 0.14) and in CAD II (1.11 +- 0.21) than in normals (1.75 +- 0.11). MBF/CO increased proportionally to the increment of the double product of heart rate and systolic blood pressure by exercise loading in normals, whereas it didn't in CAD. The sensitivity of this method was superior to the stress electrocardiogram and the stress myocardial perfusion imaging, not only in CAD II but also in CAD I. This result indicated that this type of global assessment of the myocardial reserve capacity is valuable in addition to the simple stress myocardial perfusion imaging.
PracticeClinical medicine
Keywords201Tl myocardial scintigraphy, fractional myocardial uptake, myocardial blood flow, coronary artery disease, exercise loading

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