Japanese
Title負荷Thallium-201心筋シンチグラフィーによる右室虚血性病変の評価
Subtitle原著
Authors片岡一*, 高岡茂*, 大窪利隆*, 黒岩宣親*, 大重太真男*, 中村一彦*, 橋本修治*
Authors(kana)
Organization*鹿児島大学医学部第二内科
Journal核医学
Volume19
Number10
Page1475-1482
Year/Month1982/12
Article原著
Publisher日本核医学会
Abstract「要旨」 負荷Tl-201心筋シンチ像と冠動脈造影所見との対比を行い, 右室の虚血性心病変評価における負荷Tl-201心筋シンチグラフィーの有用性につき検討した. 対象は, 有意の右冠動脈病変 (≧75%狭窄) を有する群 (RCA群) 15例と, 有さない群 (non-RCA群) 20例である. 亜最大負荷によりえられた心筋シンチ像の30度, 60度左前斜位2方向像における右室自由壁の描出度ならびに形態的特徴をわれわれの評価法により段階区分し, 以下の結論をえた. (1) RCA群では少なくとも1方向像において右室自由壁の1/2以上の描出不良 (abnormal Tl-RV) を認めた症例が15例中9例であった. これに対し, non-RCA群では20例中17例で両方向像ともに右室自由壁の1/2以上の描出が (normal Tl-RV) 認められた. (2) Normalおよびabnormal Tl-RVのcriteriaに従うと, 右冠動脈病変の検出率はsensitivity 60%, specificity 85%となる. (3) 右室自由壁描出は, 右冠動脈病変部位, 下壁梗塞合併の有無, 側副血行路の有無と関連した.
Practice臨床医学：一般
KeywordsStress thallium-201 myocardial image, Right ventricular ischemia
English
TitleStress Thallium-201 Myocardial Perfusion Imaging for Evaluation of Right-Ventricular Myocardial Ischemia
SubtitleOriginal Articles
AuthorsHajime KATAOKA, Shigeru TAKAOKA, Toshitaka OHKUBO, Nobuchika KUROIWA, Tamao OHSHIGE, Kazuhiko NAKAMURA, Shuji HASHIMOTO
Authors(kana)
OrganizationThe Second Department of Internal Medicine, Kagoshima University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume19
Number10
Page1475-1482
Year/Month1982/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Although there have been many studies on thallium (Tl)-201 myocardial imaging (TMI) for evaluation of the right ventricular overloading, there are few reports on the usefulness of this method for assessment of the right ventricle in ischemic heart disease. In this paper, we described the clinical significance of stress TMI for diagnosing the ischemic lesion of the right ventricle. The patient population fell into two distinct categories according to the findings of coronary arteriogram ; RCA group (n = 15), those individuals with significant stenosis (>=75%narrowing) in the right coronary artery (RCA), and non-RCA group (n = 20), those with no significant RCA stenosis. After the patients were exercised to 85% of the expected maximum heart rate, Tl-201 myocardial images were obtained. Presence or absence of the ischemic lesion of the right ventricle was assessed by careful observation of the appearance of the right ventricular free wall (RVFW) in 30° and 60° left anterior oblique (LAO) projections. The RVFW findings were evaluated with regard to presence or absence of the defective Tl-201 uptake, degree of Tl-201 uptake, and redistribution phenomenon, and were graded according to our criteria. In RCA group, 6 had non-visualization and 5 defective visualization of the RVFW in 30° LAO projection. In 60° LAO projection, there existed 5 non-visualization and 5 defective visualization of the RVFW. On the other hand, in non-RCA group, all except 2 in 30° LAO projection and all except 3 in 60° LAO projection demonstrated continuous visualization of the RVFW. According to our criteria of normal or abnormal "Tl-RV", the sensitivity and specificity of stress TMI for detecting the stenotic lesion in the RCA were 60% and 85%, respectively. Non-visualization and defective visualization of the RVFW on stress Tl-201 myocardial images were associated with the history of inferior myocardial infarction, marked RCA stenosis (>=90% narrowing) without collateral blood flow from the left to right coronary artery, and location of the stenotic lesion in the RCA. Collateral blood flow seemed to protect against the development of exercise-induced ischemia in the right ventricular myocardium.
PracticeClinical medicine
KeywordsStress thallium-201 myocardial image, Right ventricular ischemia

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