| Japanese |
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| Title | 拡張性心筋症における肺血流シンチ像の有用性 - デジタル肺血流像 (DPI) による評価 - |
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| Subtitle | 原著 |
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| Authors | 田中健*, 川越康博*, 笠貫宏*, 木全心一*, 関口守衛*, 広沢弘七郎*, 牧正子**, 日下部きよ子**, 重田帝子** |
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| Organization | *東京女子医科大学日本心臓血圧研究所, **放射線科 |
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| Journal | 核医学 |
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| Volume | 22 |
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| Number | 9 |
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| Page | 1361-1366 |
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| Year/Month | 1985/9 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」 拡張性心筋症 (DCM) における肺内血流分布異常を肺血流シンチ像を用いて検討した. Tc-99m-MAAは坐位で静注した. 画像をデジタル化, デジタル肺血流像とし, 辺縁は10%域とした. 肺の高さの70%と30%におけるカウント比 (distribution index : DI) によって分布異常程度を評価した. 対象としたDCM24症例には正常分布例から, 肺血流が上肺野に限局した異常例まで様々な程度の例が含まれた. mPw=12.7+7.6 DI (r=0.66, n=24, mPw : 平均肺動脈楔入圧) との良好な相関が得られ, DIによってmPwが推定し得る可能性が得られた. DI≧1はmPw≧20mmHgに対してspecificity, predictive valueともに100%であった. DI≧1に属した13例のmPwはすべて20mmHg以上であり, 10例の心機能はNYHA III°〜IV°にあり, さらに9例が2年以内に死亡していた. DI≧1でありながら臨床症状の軽い症例には特に厳重な外来管理が必要なものと考えられる. DI≧1は予後不良なことに対して有用な指標と考えられた. デジタル肺血流像は非観血的で容易に行いうる検査であるのでDCMの治療方針決定, 予後推定に有用な役割を果たすものと期待される. |
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| Practice | 臨床医学：一般 |
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| Keywords | Dilated cardiomyopathy, Distribution of pulmonary perfusion, Pulmonary hypertension, Digital perfusion images (DPI) |
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| English |
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| Title | Utility of Tc-99m-MAA Pulmonary Perfusion Images in Patients with Dilated Cardiomyopathy |
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| Subtitle | Original Articles |
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| Authors | Takeshi TANAKA*, Yasuhiro KAWAGOE*, Hiroshi KASANUKI*, Shinichi KIMATA*, Morie SEKIGUCHI*, Koshichiro HIROSAWA*, Masako MAKI**, Kiyoko KUSAKABE**, Teiko SHIGETA** |
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| Authors(kana) | |
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| Organization | *Heart Institute Japan, **Department of Radiology, Tokyo Womens' Medical College |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 22 |
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| Number | 9 |
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| Page | 1361-1366 |
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| Year/Month | 1985/9 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] To study utility of Tc-99m-MAA computerized pulmonary perfusion images (digital perfusion images : DPI) for estimating state of the patients with dilated cardiomyopathy (DCM) DPI were underwent in 24 patients with DCM. DPI were evaluated by the counts at 70% hight to the counts at 30% hight ratio (distribution index : DI) . Various types of DPI were obtained and DPI were classified to 6 grades according to patterns of hyperperfusion area in anterior DPI. Well correlation between DI and mPw (mean pulmonary artery wedge pressure) were obtained, i.e. mPw=12.7+7.6DI (r=0.66, n=24) . Specificity and predictive value of DI 1 for mPw 20 mmHg were 100% (7/7 and 13/13 respectively) . In 13 patients with DI>-1 mPw exceeded 20 mmHg, 10 of 13 patients belonged to functional class NYHA 3° & 4° and 9 patients died within 2 years. DI=1 was thought to be critical value for patients with DCM. It was concluded that asymptomatic outpatients with DI>-1 must be treated under cautious medical attension. Noninvasive DPI were expected as a useful images for establishing prognosis and selection of therapy in patients with DCM. |
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| Practice | Clinical medicine |
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| Keywords | Dilated cardiomyopathy, Distribution of pulmonary perfusion, Pulmonary hypertension, Digital perfusion images (DPI) |
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