Japanese
TitleSingle Photon Emission CTによる負荷タリウム心筋スキャンにおけるwash out rateの測定 - 特にcoronary spasmによる虚血領域, 梗塞領域について -
Subtitle原著
Authors大嶽達*, 西川潤一*, 町田喜久雄*, 南学*, 岡田吉隆*, 牧田幸三*, 小坂昇*, 伊藤正光*, 百瀬敏光*, 飯尾正宏*, 川原貴**, 戸田爲久**, 吉本信雄**, 松尾博司**, 杉本恒明**
Authors(kana)
Organization*東京大学医学部放射線科, **第二内科
Journal核医学
Volume22
Number6
Page873-883
Year/Month1985/6
Article原著
Publisher日本核医学会
Abstract「要旨」健常人10例, 虚血性心疾患30例の計40例に運動負荷および再分布時にタリウムECTを施行し, 健常領域 (N) , 虚血性心疾患非病変枝領域 (IN) , 梗塞領域 (MI) , coronary spasmによる虚血領域 (SP) , その他の虚血領域 (AP) のwash out rateを求めた. Nは45.5±7.8% (n=40) , INは38.3±10.2% (n=71) , APは28.6±10.5% (n=64) , MIは32.3±12.2% (n=38) であったが, SPは-5.3±125% (n=7) , であり, 他領域に比べ著明に低く, 負の値をとった. 非病変枝領域でも特に運動負荷が十分でない場合にwash out rateが低く, false positiveを生じた.wash out rateを用いても, 3枝病変例のもっとも軽い病変枝と1, 2枝病変例の非病変枝との鑑別は容易ではなかった. Tl wash outのメカニズムについて考察し, coronary spasm領域ではinitial uptakeが低いため, wash out rateが負となると考えた. この所見はspasmに関してある程度診断的意義があると考えられた.
Practice臨床医学：一般
KeywordsStress thallium-201 myocardial scintigraphy, Single photon emission computed tomography, Regional wash out rate, Coronary spasm, Myocardial infarction
English
TitleMeasurement of Regional Wash Out Rate in Stress Thallium-201 Myocardial Scintigraphy Using Single Photon Emission Computed Tomography - Especially in Ischemic Segment by Coronary Spasm and Myocardial Infarctional Segment -
SubtitleOriginal Articles
AuthorsTohru OHTAKE*, Junichi NISHIKAWA*, Kikuo MACHIDA*, Manabu MINAMI*, Yoshitaka OKADA*, Kozo MAKITA*, Noboru KOSAKA*, Masamitsu ITO*, Toshimitsu MOMOSE*, Masahiro IIO*, Takashi KAWAHARA**, Iku TODA**, Nobuo YOSHIMOTO**, Hiroshi MATSUO**, Tsuneaki SUGIMOTO**
Authors(kana)
Organization*Department of Radiology, **Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
JournalThe Japanese Journal of nuclear medicine
Volume22
Number6
Page873-883
Year/Month1985/6
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Wash out rate (WR) of thallium-201 was analysed in 40 cases, including 10 normal cases and 30cases with angiographically proved coronary artery disease (CAD) , by using emission computed tomography (ECT) . WR of normal segment (N) was 45.5+-7.8% (n=40) , WR of nonischemic segment of CAD (IN) was 38.3+-10.2% (n=71) , WR of ischemic segment (AP) was 28.6+-10.5% (n=64) , WR of all myocardial infarctional segment (MI (all) ) was 32.3+-12.2% (n=38) , and WR of ischemic segment by coronary spasm (SP) was -5.3+-12.5% (n=7) .WR of SP was remarkably lower than other segments and it was interesting that its value was minus. WR of infarctional segment (IS) without transient ischemia (TI) of one-vessel disease (1VD) or two-vessel disease (2VD) (MI (st) ) was 39.6+-8.8% (n=21) , WR of IS without TI of three-vessel disease (3VD) (MI (3) ) was 26.2+-5.9% (n=9) , and WR of IS with TI (MI (P) ) was 19.9+-11.3% (n=8) . WR of N was significantly higher than IN, AP, SP, MI (all) , MI (st) , MI (3) , and MI (P) (p<0.001, p<0.001, p<0.001, p<0.001, p<0.005, p<0.001, p<0.001) . WR of IN was significantly higher than AP, SP, MI (all) , MI (3) , and MI (P) (p<0.001, p<0.001, p<0.005, p<0.001, p<0.001) . WR of AP was significantly higher than MI (P) and SP (p<0.025, p<0.001) . WR of IN and MI (st) , AP and MI (all) , MI (3) were not significantly different. WR of IN was sometimes low especially when exercise was not adequate, therefore false positive might be observed. Differentiation between least severely diseased vessel of 3VD and normal vessel of 1VD or 2VD was not easy even when we used WR. We considered about mechanism of thallium wash out. In SP segment, coronary blood flow at exercise is reduced so much that initial thallium uptake may decrease very much. Then absolute count is elevated and the value of WR becomes minus. This finding maybe useful for diagnosing coronary spasm.
PracticeClinical medicine
KeywordsStress thallium-201 myocardial scintigraphy, Single photon emission computed tomography, Regional wash out rate, Coronary spasm, Myocardial infarction

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