Japanese
Title下肢虚血性疾患における201Tlおよび99mTcO4-下肢スキャンのパターン分類とその意義
Subtitle原著
Authors分校久志*, 一柳健次*, 利波紀久*, 久田欣一*, 吉田千尋**
Authors(kana)
Organization*金沢大学医学部核医学教室, **第一外科学教室
Journal核医学
Volume19
Number5
Page733-743
Year/Month1982/6
Article原著
Publisher日本核医学会
Abstract「要旨」血栓性動脈炎, 閉塞性動脈硬化症などの下肢虚血性疾患の73例について201Tlおよび99mTcO4-下肢スキャン, RIアンギオグラフィーを行い, スキャンパターンの分類とその診断的意義を検討した. 下肢スキャンは軽度の運動負荷または反応性充血時に行い, 以下の5パターンに分類された. (A)患側肢の全体的な集積低下, (B)患側肢の一部の集積低下, (C)患側肢の一部の集積低下とその近位または遠位の集積増加, (D)患側肢の一部または全体的な集積増加, (E)左右差なし. (A), (B)は虚血を, (C)は反応性充血を伴なう虚血を, (D)は反応性充血を示すと考えられた. 201Tlおよび99mTcO4-下肢スキャン, RIアンギオグラフィーの併用は下肢虚血性疾患の検出率(98%), 特異性(100%)が高く, スクリーニング検査として有用であり, 治療前後の評価, 経過観察に有用であった.
Practice臨床医学：一般
KeywordsLeg scan patterns, 201Tl, 99mTcO4-, ischemic disease, lower extremities.
English
TitleClassification of 201Tl-pertechnetate Leg Scan Patterns and Evaluation of their Clinical Significance
Subtitle
AuthorsHisashi BUNKO, Kenji ICHIYANAGI, Norihisa TONAMI, Kinichi HISADA, Chihiro YOSHIDA
Authors(kana)
OrganizationDepartment of Nuclear Medicine and First Department of Surgery, School of Medicine, wanazawa University
JournalThe Japanese Journal of nuclear medicine
Volume19
Number5
Page733-743
Year/Month1982/6
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Classification of the 201Tl and 99mTc-pertechnetate (99mTcO4-) leg scan patterns and their clinical significance were evaluated in the patients with ischemic diseases of the lower extremities (IDL) Seventy-three patients including 14 patients with thrombo-arteritis obliterans (TAO), 32 with arteriosclerosis obliterans (ASO), 9 with diabetic gangrene, Raynaud's disease or acute arterial thrombosis, 5 normals and 13 patients after surgery for LDL were included in the study. 201Tl leg scan was obtained by i. v. injection of 2 mCi of 201Tl after mild exercise or at reactive hyperemia following the release of compression of the bilateral thigh using whole body gamma camera. 99mTcO4- leg scan was obtained 20 min after radionuclide angiography of the lower extremities. Five patterns were distinguished in both 201Tl and 99mTcO4- leg scans; A: decreased activity throughout the affected leg, B: localized decreased activity in the affected leg, C: localized decreased activity associated with increased activity in the affected leg, D: generalized or localized increased activity in the affected leg and E: no laterality of the activity. 201Tl and 99mTcO4- leg scan patterns were agreed in 55% of the patients. 201Tl leg scan had tendency to correlate the level of the vascular lesion in pattern B and C, however, diagnosis of the level of the lesion was difficult from the leg scan. Pattern D of the 201Tl leg scan was associated with increased blood flow in the affected leg on radionuclide angiography in 42% of the patients. After surgery, 99mTcO4- leg scan tended to show pattern D, especially in the patients with lumbar sympathectomy. Patterns A, B and C were thought to suggest the ischemia. Patterns C and D were thought to express reactive hyperemia induced by the ischemic lesion. In the 60 preoperative IDL, sensitivity of 201Tl leg scan alone was 76% and that of combined use of 201Tl and 99mTcO4- leg scans was 85%. Addition of radionuclide angiography increased sensitivity of IDL upto 98% and accuracy was 98%. Combined use of 201Tl and 99mTcO4- leg scans and radionuclide angiography was useful for detection of IDL, and was also useful for evaluation of the results of the surgical intervention.
PracticeClinical medicine
KeywordsLeg scan patterns, 201Tl, 99mTcO4-, ischemic disease, lower extremities.

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