Japanese
Title僧帽弁狭窄症におけるデジタル肺血流像 (DPI) の特徴
Subtitle原著
Authors田中健*, 木全心一*, 広沢弘七郎*, 牧正子**, 日下部きよ子**, 山崎統四郎**
Authors(kana)
Organization*東京女子医科大学日本心臓血圧研究所, **東京女子医科大学放射線科, ***放射線医学総合研究所
Journal核医学
Volume19
Number2
Page223-237
Year/Month1982/3
Article原著
Publisher日本核医学会
Abstract「要旨」肺内血流分布を評価するためにTc-99m MAAによる肺血流像を計算機処理し, 等カウント域像としたデジタル肺血流像(DPI)を導入した. 僧帽弁狭窄症60症例をDPIパターンによって6段階に分類した. G-0: 正常例, G-1: 上肺野低肺血流域の消失, G-2: 下肺野下縁高肺血流域の消失, G-3: 上肺野に高肺血流域が限局, G-4: 下肺野に低肺血流域が出現, E: 重症例(NYHA 4度). 平均肺動脈圧はG-0では約10mmHg, G-1とG-2では約20 mmHg, G-3では約30 mmHg, G-4では約40mmHg Eでは50 mmHg以上と有意な差が認められた. G-1とG-2の間では肺血管抵杭(p<0.05), 心係数(p<0.001)で有意な差が認められた. 重症例では下肺野低肺血流域の有無によって肺内血流分布は二種類に分類され, 低肺血流域が認められない場合は肺血管抵杭は有意に高く(p<0.01), 心係数は有意に低い(p<0.001)ことが認められた. さらにこのDPIパターン分類は単位肺血流量分布の観点からも有意義と考えられた. 画像診断法としてDPIは僧帽弁狭窄症評価に有用と考えられた.
Practice臨床医学：一般
KeywordsDigital perfusion images(DPI), Mitral stenosis, Pulmonary perfusion per unit lung volume (PPL), pulmonary redistribution index(PRI).
English
TitleCharacteristics of Digital Perfusion Images (DPI) in Mitral Stenosis
Subtitle
AuthorsTakeshi TANAKA*, Shinichi KIMATA*, Koshichiro HIROSAWA*, Masako MAKI**, Kiyoko KUSAKABE**, Toshiro YAMAZAKI***
Authors(kana)
Organization*Heart Institute Japan, **Department of Radiology, Tokyo Women's Medical College, ***National Institute of Radiological Science
JournalThe Japanese Journal of nuclear medicine
Volume19
Number2
Page223-237
Year/Month1982/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractDistribution of pulmonary perfusion in 60 patients with mitral stenosis was studied by using computerized Tc-99m-MAAperfusion images(digital perfusion images; DPI). DPI were consisting of isocount contours(iso)and 100-84% iso were defined as hyperperfusion area(HY)and 21-7% iso as hypo-perfusion area(HO). Patterns of DPI were classified to 6 grades. G-0; normal subjects, G-1; disappearance of apical HO, G-2; disappearance of basal HY at anterior DPI, G-3; limitation of HY to upper zone of DPI, G-4; appearance of basal HO and E; severe patients with HYHA class 4. For semiquantitative estimation of this classification pulmonary redistribution index(PRI)=(counts at third intercostal space)(counts at basal zone)were introduced and relationship between this classification and PRI was discussed. This classification proved to be hemodynamically significant and mean pulmonary artery pressure(mPA)of G-0 was about 10 mmHg, G-1 about 20mmHg, G-2 about 20 mmHg, G-3 about 30mmHg, G-4 about 40 mmHg and E about 55mmHg. There was no significant differences in mPA between G-1 and G-2, however significant differences were noted in cardiac index(CI), i. e. G-1 about 2.9 L/m M2 and G-2 about 2.2 L/m M2. By using patterns of DPI it proved to be possible to estimate pulmonary hemodynamics. It was shown that there were at least two types of DPI in E. In one type no HO were noted, i. e. type A and in other type marked HO were noted at lower zone of DPI, i. e. type B. There were significant differences in CI(p.001)and pulmonary resistance (p.01). Type A proved to be that of pulmonary hypertension with both low output and high pulmonary resistance. From the stand point of pulmonary perfusion per unit lung volume this classification might prove to be significant and pathophysiologically interesting results were suggested. At early stage of mitral stenosis(G-1)elevation of mPA and disappearance of apical HO may occur and CI may relatively maintained and at next stage(G-2)basal vasoconstriction may occur and CI may decrease without elevation of mPA. At end stage significant relationship may be suggested between cardiac index and basal hypoperfusion area.
PracticeClinical medicine
KeywordsDigital perfusion images(DPI), Mitral stenosis, Pulmonary perfusion per unit lung volume (PPL), pulmonary redistribution index(PRI).

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