Japanese
Title運動負荷心筋スキャンによる虚血の検出およびその重症度評価 - 肺野の201TlCl集積, washout rateの併用による -
Subtitle原著
Authors西村恒彦*, 植原敏勇*, 林田孝平*, 小塚隆弘*, 住吉徹哉*, 斉藤宗靖*, 平盛勝彦*
Authors(kana)
Organization*国立循環器病センター放診部内科
Journal核医学
Volume22
Number4
Page467-475
Year/Month1985/4
Article原著
Publisher日本核医学会
Abstract「要旨」冠動脈造影を施行している労作性狭心症 (梗塞非合併例) 126症例を対象として, 運動負荷心筋スキャンを施行, 虚血の検出とその重症度評価を検討した. 一過性欠損像の検出では虚血の検出率はSVD, DVD, TVDにて73%, 92%, 97%であった. しかし, DVDにて37例中20例 (54%) に1冠動脈支配領域に, TVDにて37例中14例 (38%) に1冠動脈支配領域のみに, 20例 (54%) に2冠動脈支配領域のみに欠損像を認め, 必ずしも罹患冠動脈全領域に再分布は出現しなかった. 一方, washout rate analysisの併用によりTVDにて25例 (68%) に心筋全周囲のslow washoutを認めた. さらに, 負荷時心筋像から算出した肺野の201TlCl集積は, 冠動脈病変の狭窄度および狭窄枝数の増加とともに上昇した. したがって, 通常用いられている一過性欠損像の検出に加え, washout rateの算出および肺野の201TlCl集積の算出は, 虚血の検出精度の向上とその重症度判定に有用なことが示唆された.
Practice臨床医学：一般
KeywordsStress thallium scan, myocardial ischemia, Transient defect, Washout rate, Lung thallium uptake
English
TitleEnhanced Detection of Myocardial Ischemia by Stress Thallium Scan : Assessment by Washout Rate Analysis and Lung Thallium Uptake in Addition to Transient Defect Analysis
SubtitleOriginal Articles
AuthorsTsunehiko NISHIMURA, Toshiisa UEHARA, Kohei HAYASHIDA, Takahiro KOZUKA, Tetsuya SUMIYOSHI, Muneyasu SAITO, Katsuhiko HIRAMORI
Authors(kana)
OrganizationDepartment of Radiology and Cardiology National Cardiovascular Center
JournalThe Japanese Journal of nuclear medicine
Volume22
Number4
Page467-475
Year/Month1985/4
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] The detection of myocardial ischemia by stress thallium scan was usually performed using transient defect (TD) analysis from exercise and redistribution images. Furthermore, washout rate analysis and lung thallium uptake may also provide diagnostic assistance to assess the severity of myocardial ischemia. We applied these combined method to evaluate myocardial ischemia more accurately in 126 cases of effort angina pectoris without myocardial infarction. All patients had coronary angiography and then divided into single, double and triple vessel diseases (SVD, DVD, TVD) . The detection of ischemia in SVD, DVD and TVD by TD analysis was 73%, 92%and 97%, respectively. However, TD analysis misdiagnosed some patients with extensive coronary artery disease. In our cases, 20/37 (54%) of DVD and 14/37 (38%) of TVD had only 1 TD and 20/37 (54%) of TVD had 2 TD. This limitation was caused since TD relies on relative perfusion defect analysis. On the other hand, washout rate analysis based on the non-relative perfusion defect. Diffuse slow washout (washout rate ; less than 40%) of myocardium was observed in 25/37 (68%) cases of TVD. In addition, lung thallium uptake more than 33% (Mean+2 SD) was considered as abnormal findings. Elevated lung thallium uptake was observed in the case with severe coronary artery stenosis and multivessel disease. In conclusion, washout analysis and lung thallium uptake in addition to TD analysis improved the accuracy of detection of myocardial ischemia, and severity of myocardial ischmeia was also evaluated by these combined method. Therefore, these analysis should be performed in the interpretation of stress thallium scan.
PracticeClinical medicine
KeywordsStress thallium scan, myocardial ischemia, Transient defect, Washout rate, Lung thallium uptake

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