| Japanese |
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| Title | 虚血性心疾患における運動負荷Thallium-201心筋イメージングの検討 - Thallium-201肺野集積の臨床的意義について - |
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| Subtitle | 原著 |
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| Authors | 松下一夫* |
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| Organization | *岩手医科大学第二内科 |
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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 | 777-785 |
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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」負荷Tl-201心筋イメージング(MPI)の際の, 1)負荷量, 2)虚血性心疾患(IHD)の検出率, 3)負荷直後のTl-201肺野集積とIHDの重症度との関係について検討した. その結果, 1)負荷Tl-201 MPI陰性例は負荷量が不十分で, 自転車エルゴメーターによる負荷方法は必ずしも適当でないと考えられ, 2)IHDの検出率は62%であり, 3)Tl-201 Lung indexは冠状動脈の多枝障害例で増加していて, 左室駆出率とは負の(γ=-0.64), 左室拡張終期圧とは正の(γ=0.44)相関傾向を示し, 負荷Tl-201 MPIにおける心機能の評価, 冠状動脈病変の重症度の判定に際し有用な指標であると考えた. 「I. はじめに」近年, 生活様式の欧米化に伴い虚血性心疾患(以下IHDと略す)は増加の傾向にある. そのスクリーニングとしては, 従来, 負荷心電図法が主体であり, 確定診断には選択的冠状動脈造影が行われてきた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Tl-201, Myocardial perfusion imaging, Ischemic heart disease, Ergometer exercise, Lung uptake. |
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| English |
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| Title | Investigation of Exercise Thallium-201 Myocardial Perfusion Imaging in Patients with Ischemic Heart Disease - Clinical Significance of Thallium-201 Lung Uptake - |
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| Subtitle | |
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| Authors | Kazuo MATSUSHITA |
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| Authors(kana) | |
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| Organization | The Second Department of Internal Medicine, Iwate Medical 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 | 777-785 |
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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]Recently it has been reported that an increased Thallium-201 (Tl-201) lung uptake has been observed in exercise myocardial perfusion images (MPI) for patients with ischemic heart disease (IHD). In order to assess problems of exercise method, detectability, and the clinical significance of lung Tl-201 activity, initial and four-hour delayed Tl-201 images were stored after bicycle ergometer exercise for 18 patients (13 with IHD and 5 with normal coronary angina syndrome). Regions of interest were selected over the heart and lung, and the quantitative Tl-201 lung uptake was shown by the percentage of maximal Tl-201 lung index. The Tl-201 lung index was compared with the extent of IHD at coronary angiography, resting left ventricular ejection fraction (LVEF), and resting left ventricular end-diastolic pressure (LVEDP). The diagnotic value of stress MPI for detecting IHD was 62%. The insuffeciency of exercise may be the reason for the negative stress MPI of certain patients with IHD. The initial mean Tl-201 lung index of the five normal control patients was 28.5+-2.5% (+-SD) and that of the 13 patients with IHD was 37.6+-9.4% (p<0.05 compared with controls). The mean Tl-201 lung indices of the patients with one-vessel, two-vessel, and three-vessel coronary artery disease were 32.2+-11.4%, 37.2+-4.7% (p<0.02), and 40.1+-10.2% (p<0.05), respectively. The correlation coefficient between LVEDP and Tl-201 lung index was 0.44 and that between LVEF and Tl-201 lung index was -0.64. Assuming patients with the Tl-201 lung index above 33.5% (2 SD above the mean of normal control) to be abnormal, their LVEF was 53.7+-12.6%, a significantly low value compared with the normal Tl-201 lung index, i. e. , 68.5+-7.1% (p<0.01). We concluded that the finding of elevated Tl-201 lung uptake in stress myocardial images was correlated with increased severity of underlying coronary artery disease and left ventricular disfunction. |
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| Practice | Clinical medicine |
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| Keywords | Tl-201, Myocardial perfusion imaging, Ischemic heart disease, Ergometer exercise, Lung uptake. |
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