Japanese
TitleKr-81mによる間質性肺炎の換気・血流分布の検討
Subtitle原著
Authors関根広*, 川上憲司*, 島田孝夫**
Authors(kana)
Organization*東京慈恵会医科大学放射線科, **第三内科
Journal核医学
Volume20
Number9
Page1307-1317
Year/Month1983/11
Article原著
Publisher日本核医学会
Abstract「要旨」 間質性肺炎12症例について, Kr-81mを用いて気道および血管系の器質的変化について検討した. Kr-81mボーラス吸入法を低肺気量位, 安静呼気位, 高肺気量位より行い, また連続吸入法とKr-81mブドー糖液連続静注法により局所換気血流比 (V/Q) の分布を求めた. さらに7例については運動負荷を加え, V/Qの変化について検討した. 進行例では, 高肺気量位よりのボーラス吸入で下肺野の放射能が弱く, 低肺気量位よりのボーラス吸入では下肺野まで放射能が認められた. このことは, 下肺野におけるコンプライアンスの低下を示唆する所見である. しかしながら, 初期例あるいは可逆的症例ではボーラス吸入法は正常パターンを示した. 運動負荷を施行した7例中6例において, 安静時よりすでにV/Qが上下肺においてやや均等化し, 3例は10W〜20Wの軽い負荷で均等化が著明となった. このことは, 進行例では安静時より上肺野の血流増加が認められ, 軽度の負荷でそれが著明になったためと考えられる. しかしながら, 初期あるいは可逆的症例については, PaO2の減少がありながら40Wの負荷に耐え, 正常同様のV/Qの上下肺における均等化を示した. したがって, 負荷量, V/Q分布の変化, およびPaO2の変化より, 初期あるいは可逆的な間質性肺炎を推定できると考えられる.
Practice臨床医学：一般
KeywordsKrypton-81m, Interstitial pneumonia, Ventilation-perfusion ratio, Exercise, Blood gas
English
TitleRegional Distribution of Ventilation-perfusion Ratio in Patients with Interstitial Pneumonia Using Kr-81m
SubtitleOriginal Articles
AuthorsHiroshi SEKINE*, Kenji KAWAKAMI*, Takao SHIMADA**
Authors(kana)
Organization*Department of Radiology, **Third Division, Department of Internal Medicine, Jikei University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume20
Number9
Page1307-1317
Year/Month1983/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] In order to know the pathophysiological change of interstitial pneumonia, it is important to detect the morphological change of vascular and air way systems in the lung. The study group consisted of 12 patients of interstitial pneumonia including IIP, PSS, RA, sarcoidosis, and hypersensitive pneumonia. The Kr-81m bolus inhalation from 3 different lung volumes were analyzed to detect regional ventilation abnormalities. The regional distribution of ventilation-perfusion ratio (V/Q) in the lung was obtained from the continuous inhalation and infusion Kr-81m. In 7 patients, regional distribution of V/Q was also measured at rest and during exercise. In advanced stage of interstitial pneumonia, radioactivity in lower lung fields was decreased in bolus inhaltion from TLC-400 ml lung volume, and present in lower lung in bolus inhalation from RV level These findings are representing air way rigidity especially in lower lung fields. However, in early stage or reversible cases, it is difficult to detect the abnormal distribution of radioactivity in lung, in spite of decreased PO2. So it seems impossible to screen early stage or reversible cases of interstitial pneumonia by bolus inhalation method alone. At rest for normal subjects in the upright position, the apical zone had a high V/Q, but in the lower parts two third of V/Q distribution was relatively homogeneous. During exercise at 50W, the distribution became more uniform. In most cases of the disease, weak exercise (less than 40W) produced the same uniform V/Q distribution. It should be noted that in the disease not only was perfusion in upper lung fields increased, but that perfusion of lower lung fields was reduced. So late in the cource of extension of the disease, pulmonary vascular bed in the lower lung fields is restricted. However, in early stages or reversible cases, V/Q distribution at rest and with exercise at some 40W produced same change as normal subject in spite of decreased PO2. So, it seems possible to differentiate early stage or reversible cases from advanced cases by the exercise with monitoring PO2.
PracticeClinical medicine
KeywordsKrypton-81m, Interstitial pneumonia, Ventilation-perfusion ratio, Exercise, Blood gas

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