Japanese
Title各種心疾患におけるTl-201心筋イメージの乳頭筋描出所見の分析
Subtitle原著
Authors片岡一*, 田淵博己*, 大窪利隆*, 高岡茂*, 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
Volume22
Number1
Page19-27
Year/Month1985/1
Article原著
Publisher日本核医学会
Abstract「要旨」Tl-201心筋イメージの乳頭筋 (PM) 描出所見を分析した. 対象は健常群20例, IHD 78例, HCM 11例, DCM 13例で, 運動負荷直後と再分布の心筋イメージを正面, 左前斜位30度, 60度, 左側面で撮像した. PMは解剖学的付着部位に一致して限局性心腔内突出, 放射性活性増強をもって判定し, 運動負荷直後と再分布像の描出所見の推移により, immediately enhanced, unchanged, delayed enhancedの3型に分類した. (1) 前側PMの出現頻度は16/122例で各群に差はないが, 後内PMの出現頻度は40/122例で, 特にIHD 28/78例, DCM 7/13例では健常群に比し高い. (2) LAD1枝病変例, ことに虚血出現例での後内PMの出現は健常群に比し高いが (15/18例, P<0.001), LAD領域に虚血を有する多枝病変例では8/25例と低下し, LAD1枝病変例に比し低い (P<0.01). 2枝病変の3例でPM再分布陽性であった. (3) 重症多枝病変例のPM描出はDCM例に比し低く, 鑑別の一助となるが, 必ずしも鋭敏な指標ではなかった. 後内PMはRCA, LCxよりの灌流をうけるが, IHD群では罹患冠状動脈病変の差を反映してPM描出も異なった所見をとる. IHD群のplanarの心筋イメージのPM描出には, PMに重なって存在する左室心筋とPMへの冠血流支配の健全性の関与が大きいと考えられた.
Practice臨床医学：一般
KeywordsThallium-201 myocardial image, Papillary muscle, Ischemic heart disease, Idiopathic cardiomyopathy
English
TitleAnalysis of the Papillary Muscle Image on Thallium-201 Myocardial Scintigram in Various Heart Diseases
SubtitleOriginal Articles
AuthorsHajime KATAOKA, Hiromi TABUCHI, Toshitaka OHKUBO, Shigeru TAKAOKA, Kazuhiko NAKAMURA, Shuji HASHIMOTO
Authors(kana)
OrganizationThe Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University
JournalThe Japanese Journal of nuclear medicine
Volume22
Number1
Page19-27
Year/Month1985/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] The papillary muscle (PM) image on thallium (Tl)-201 myocardial scintigram was analyzed. The subjects included 20 normal ones, 78 ischemic heart disease (IHD), 11 hypertrophic cardiomyopathy and 13 dilated cardiomyopathy (DCM). Stress Tl-201 myocardial images were obtained from the subjects except DCM patients who underwent only the rest imaging. Serial myocardial imaging was started 5-10 min and 3-4 hr after exercise. On each imaging, 4 views were obtained. On scintigrams, the presence or absence of the PM image was evaluated. The PM image was accepted if either of the following findings was present at the scintigraphic myocardial site corresponding to the anatomical portion of the PM insertion: 1) the presence of the localized protruding figure from the myocardial wall into the cavity; 2) localized tracer accumulation. The serial PM images were classified as: 1) immediately enhanced pattern; 2) unchanged pattern; and 3) delayed enhanced pattern. Posteromedial (pm.) PM was frequently observed in IHD and DCM. However, anterolateral PM was not so frequently observed in this study. In IHD, the incidence of the positive pm. PM image was significantly high among the patients with single vessel disease (SVD) of the left anterior descending artery (LAD), particularly those accompanying the ischemia. However, the patients with double vessel-(DVD) or triple vessel disease (TVD), even if the presence of the ischemia of the myocardium supplied by the LAD, did not tend to disclose the pm. PM image. When comparing the PM image between the patients with DVD or TVD accompanying the severe LV dysfunction and DCM patients, the incidence of the positive PM tended to be high in DCM. In conclusion, PM image on scintigram was frequently observed in the IHD patients, particularly those with SVD of the LAD, and in DCM patients. In IHD, exercise stress seemed to bring about the positive pm. PM by increased Tl uptake of the PM and decreased Tl uptake of the anterior left ventricular wall overlying the pm. PM.
PracticeClinical medicine
KeywordsThallium-201 myocardial image, Papillary muscle, Ischemic heart disease, Idiopathic cardiomyopathy

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