Japanese
Title左心室瘤症例における核医学的診断に関する研究
Subtitle原著
Authors西村恒彦*, 植原敏勇*, 内藤博昭*, 林田孝平*, 小塚隆弘*
Authors(kana)
Organization*国立循環器病センター放診部
Journal核医学
Volume18
Number1
Page13-21
Year/Month1981/1
Article原著
Publisher日本核医学会
Abstract「要旨」 心筋梗塞後の左心室瘤の存在診断は, 梗塞症例における経過観察, 予後判定および手術適応の決定に重要である. そこで, 左心室瘤30症例を対象として心RIアンジオグラフィ, 心筋シンチグラフィを施行, 併せ, 心エコー図, 心カテーテル検査における成績と対比することにより左心室瘤の核医学的診断の有用性について検討した. 心RIアンジオグラフィにて左心室瘤をapical, aneurysmal, hypokinesisの3型に分類したところ局所壁運動は, 心エコー図, 左室造影のそれとよく一致した. しかし血栓検出に関しては心エコー図が優れていた. また心筋シンチグラフィでは各型に応じた欠損部位, 拡がりを認めた. 左室造影を施行している20症例にて, 駆出分画を比較すると0.79の相関を, また, %Tl defectと左室造影による梗塞周径比は0.73の相関を示し, 本法は非観血的に診断のみならず経過観察, 手術前後の比較に役立つことが認められた.
Practice臨床医学：一般
KeywordsLeft ventricular aneurysm, Radionuclide cardioangiography, Myocardial perfusion scintigraphy, Segmental wall motion, Ejection fraction
English
TitleClinical Assesment of Post-infarction Left Ventricular Aneurysm by Radionuclide Study
Subtitle
AuthorsTsunehiko NISHIMURA, Toshiisa UEHARA, Hiroaki NAITO, Kohei HAYASHIDA, Takahiro KOZUKA
Authors(kana)
OrganizationDepartment of Radiology and Nuclear Medicine, National Cardiovascular Center
JournalThe Japanese Journal of nuclear medicine
Volume18
Number1
Page13-21
Year/Month1981/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Left ventricular failure or congestive cardiac failure after myocardial infarction may be the results of a localized left ventricular aneurysm or of global ventricular hypokinesis. Detection of post-infarction left ventricular aneurysm is important to determine the prognosis and surgical treatment. In this study, by radioisotope technique, clinical assessments of left ventricular aneurysm were performed in 30 patients with a history of previous myocardial infarction. 20 patients of all were also studied with contrast ventriculography and echocardiography and remaining 10 patients were studied with echocardiography noninvasively. The types of left ventricular aneurysm were classified into three groups by the sequential wall motion of left ventricle by first pass and multigated cardioangiography. (1) apical (a, dyskinesis of Seg. 3) , (2) aneurysmsl (a, dyskinesis of Seg. 2, 3, 4) , (3) hypokinesis (a, dyskinesis of Seg. 2, 3, 4 and reduced motion of 1, 5) . In thallium scintigraphy, 30 patients of left ventricular aneurysm had transmural perfusion defect in all cases and these three types of left ventricular aneurysm are corresponded with the extension of perfusion defect in thallium scintigraphy respectively. Therefore, by these combined methods, left ventricular aneurysm were detected noninvasively. For the function of the patients with left ventricular aneurysm, ejection fraction calculated from the contrast left ventriculogram were correlated well with radionuclide ejection fraction by counts method (r=0.79) . Percent thallium defect area were also correlated well with the percent non-contracted segments of left ventriculogram. By these methods, the function of the patients with left ventricular aneurysm were also evaluated clinically. For the detection of mural thrombosis, echocardiographic findings were superior than radionuclide methods, however, echocardiography was inferior to the assessment of function of left ventricular aneurysm. In conclusion, these radionuclide methods were believed to be useful for the follow up and indication of surgical treatment in the patients with post-infarction left ventricular aneurysm.
PracticeClinical medicine
KeywordsLeft ventricular aneurysm, Radionuclide cardioangiography, Myocardial perfusion scintigraphy, Segmental wall motion, Ejection fraction

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