Japanese
Title運動負荷タリウム心筋像による冠動脈病変部位の非観血的診断
Subtitle原著
Authors河合直樹*, 岡田充弘*, 都田裕之*, 志貴一仁*, 都築雅人*, 稲垣春夫*, 近藤照夫*, 横田充弘*, 外畑巌*, 安部哲太郎**, 山本秀平***, 都築実紀****
Authors(kana)
Organization*名古屋大学医学部第一内科, **名古屋大学附属病院中央放射線部, ***名古屋第二日赤病院内科, ****大同病院内科
Journal核医学
Volume20
Number4
Page371-383
Year/Month1983/5
Article原著
Publisher日本核医学会
Abstract「要旨」心筋梗塞の既往のない労作狭心症57例を対象として, 運動負荷201Tl心筋像の冠動脈病変局在診断能を検討した. (1)1枝病変および左主幹部単独病変例の成績より, 201Tl心筋像上の各冠動脈支配領域を決定した. (2)冠動脈病変局在の診断感度は1枝病変に比し, 多枝病変ではやや低かった. 3枝病変例では201Tl washout rateの計測が感度向上に有用であった. 診断特異度はどの冠動脈も良好であった. (3)冠動脈病変局在の診断感度に影響を及ぼす因子としては, 多枝病変では問題とする冠動脈枝の絶対的狭窄度よりも他の冠動脈枝との相対的狭窄度の方が重要と考えられた. 側副血行の存在は冠動脈枝の診断感度に有意な影響を与えないものと考えられた. 運動負荷201Tl心筋像は1枝病変例の冠動脈有意狭窄枝の診断, あるいは多枝病変例でも最も高度で問題となる冠動脈病変の検出には十分信頼性の高い非観血的検査法と考えられた.
Practice臨床医学：一般
Keywordsstress thallium myocardial imaging, angina pectoris, coronary artery disease, sensitivity.
English
TitleNoninvasive Diagnosis of Coronary Arterial Lesions by Exercise Thallium-201 Myocardial Perfusion Imaging
Subtitle
AuthorsNaoki KAWAI*, Mitsuhiro OKADA*, Hiroyuki MIYAKODA*, Kazuhito SHIKI*, Masato TSUZUKI*, Haruo INAGAKI*, Teruo KONDO*, Mitsuhiro YOKOTA*, Iwao SOTOBATA*, Tetsutaro ABE**, Schuhei YAMAMOTO***, Jitsuki TSUZUKI****
Authors(kana)
Organization*First Department of Internal Medicine, Nagoya University School of Medicine, **Department of Radiology, Nagoya University Hospital, ***Department of Internal Medicine, Nagoya Second Red Cross Hospital, ****Department of Internal Medicine, Daido Hospital
JournalThe Japanese Journal of nuclear medicine
Volume20
Number4
Page371-383
Year/Month1983/5
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractThe value of exercise thallium-201 myocardial perfusion imaging (Ex MPI) for identifying diseased coronary arteries was evaluated in effort angina patients without previous myocardial infarction. The material consisted of 57 effort angina patients without previous MI. Stress and redistribution Tl-201 myocardial imaging was performed, and initial Tl-201 uptake and washout rate were assessed in LV wall segments. The territory of the individual major coronary artery on myocardial images was determined by analysis of the site of perfusion defects in 29 patients with single vessel or isolated left main disease. The anteroseptal wall was considered as the territory of the left anterior descending artery (LAD). The inferior and the posterolateral walls were assumed to be supplied by the right coronary (RCA) and the left circumflex (LCX) arteries, respectively. Ex MPI was sensitive for identifying the diseased artery in single vessel disease, the sensitivity being 86% for LAD, 66% for LCX and 71% for RCA. However, the sensitivity tended to decrease as the number of diseased vessels increased. An improved sensitivity was observed by analysis of the regional myocardial washout rate of thallium-201 in patients with triple vessel disease, in which the criterion of Tl-201 perfusion defect was not sensitive. Ex MPI was highly specific for individual coronary artery disease. Several factors supposed to affect the sensitivity of Ex MPI for detection of individual lesions were analysed. The sensitivity increased, in general, with the severity of stenosis and it was lower for a less severely diseased artery in multiple vessel disease. The presence or absence of coronary collaterals seemed not to affect the sensitivity of Ex MPI. In conclusion, Ex MPI was considered to be a useful noninvasive technique to detect the diseased coronary arteries in patients with single vessel disease or the most severely diseased artery in patients with multiple vessel disease.
PracticeClinical medicine
Keywordsstress thallium myocardial imaging, angina pectoris, coronary artery disease, sensitivity.

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