| Japanese |
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| Title | 急性心筋梗塞初期診療における心筋シンチグラフィの検討 |
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| Subtitle | 原著 |
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| Authors | 廖仁貴*, 高谷淳*, 山本睦夫*, 早瀬武夫**, 小野清純**, 佐々木康人***, 柏田和子***, 染谷一彦*** |
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| Organization | *茅ケ崎市立病院循環器内科, **放射線科, ***聖マリアンナ医科大学第三内科 |
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| Journal | 核医学 |
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| Volume | 19 |
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| Number | 5 |
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| Page | 711-720 |
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| Year/Month | 1982/6 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」胸痛発作後出来るだけ早期に心筋シンチグラムを実施することにより, 急性心筋梗塞初期診療における核医学検査の有用性を検討した. 胸痛発作を訴えて来院し, 臨床症状, 心電図, 酵素検査より急性心筋梗塞(AMI)と診断(12例), または疑われた(4例), 計16症例を対象とした. AMI症例の92%(11/12)は99mTc-PYPの異常集積と201TI心筋イメージ上の欠損を認めた. AMI疑い症例の50%(2/4)は核医学検査で陽性であった. ECG, 血清酵素所見の得られない情報をもたらし, AMIの早期診断に心筋スキャンがきわめて有用であった症例は3, 心筋スキャンがもっと早期に実施されていたらきわめて有用な情報を提供しえたと考えられる症例は2, 心筋スキャンがECGおよび血清酵素の結果を支持したのが9例, 他の2例は, ECGおよび血清酵素の結果と一致しなかった. 一般病床際での核医学検査は, 法的制約のため実施がきわめて困難な現状であるが, もっと早期に核医学検査が実施される機会があれば胸痛発作患者の鑑別診断における有用性がさらに実証されると考える. |
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| Practice | 臨床医学：一般 |
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| Keywords | Acute Myocardial Infarction, Myocardial Scintigraphy, 201TlCl, 99mTc-PYP. |
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| English |
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| Title | Evaluation of Myocardial Scintigraphy for the Primary Care of Acute Myocardial Infarction |
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| Authors | Yoshitaka RYO*, Jun TAKAYA*, Mutsuo YAMAMOTO*, Takeo HAYASE*, Kiyotsumi ONO*, Yasuhito SASAKI**, Kazuko KASHIWADA** |
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| Authors(kana) | |
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| Organization | Department of Cardiology *Department of Radiology, Chigasaki Municipal Hospital, **The 3rd Department of Internal Medicine, St. Marianna University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 19 |
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| Number | 5 |
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| Page | 711-720 |
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| Year/Month | 1982/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]We have evaluated the usefulness of myocardial scintigraphy in the primary care of patients with chest pain attack by performing the scintiscan at the earliest possible periods after attack. Materials included 16 patients with chest pain admitted through emergency room being diagnosed as AMI (12 cases) or suspected of AMI on the basis of clinical findings and conventional examinations including ECG and serum enzyme levels. Of 12 patients with AMI 11 revealed abnormal accumulation of 99mTc-PYP and focal defects in 201Tl myocardial imaging. One case gave false negative results in both studies with 99mTc-PYP and 201TlCl. Early nuclear medicine examinations in one patient with suspected AMI revealed negative result. The patient was diagnosed later as acute pericarditis. Among 3 other patients with suspected AMI 2 showed positive and one showed negative results for AMI in scintigraphies. We believe that the nuclear medicine procedures definitely contributed to the early diagnosis of AMI in 3 patients as they provided useful informations that ECG and serum enzyme did not provide. In two patients extremely useful informations would have been obtained, if scintigrams had been performed earlier. In 9 patients scintigrams supported the diagnosis made by conventional examinations. In two patients scintigraphy gave inconsistent results with those obtained by conventional procedures. Myocardial imaging should prove useful in early differential diagnosis of chest pain patients, if the opportunity to perform the procedures increases, which is extremely limited at present because of legal restriction to the use of radioisotopes at bed side. |
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| Practice | Clinical medicine |
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| Keywords | Acute Myocardial Infarction, Myocardial Scintigraphy, 201TlCl, 99mTc-PYP. |
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