Japanese
Title心電図同期Single Photon Emission Computed Tomographyによる左室逆流性疾患の定量的評価
Subtitle原著
Authors滝淳一*, 分校久志*, 中嶋憲一*, 南部一郎*, 四位例靖*, 谷口充*, 利波紀久*, 久田欣一*
Authors(kana)
Organization*金沢大学医学部核医学科
Journal核医学
Volume24
Number2
Page137-141
Year/Month1987/2
Article原著
Publisher日本核医学会
Abstract「要旨」心電図同期SPECTを用いて左室逆流性弁膜疾患の定量的評価を試みた. 対照群20例の逆流率(RF)は2.3±8.6%, 逆流群20例のRFは41.0±15.6%と有意に高値を示した(p<0.001). Sellers I〜II度のRFは32.8±13.5%(n=8), III度のRFは49.9±13.5%(n=7)といずれも対照群に比して高値を示し(p<0.001), また両群間にも有意差を認めた(p<0.05). 心カテーテル検査より求めたRF(X)とSPECTによるRF(Y)との間にはY=0.78X+7.7(%), r=0.853, n=9と良好な相関を認めたが, 心カテとPlanar像によるRFの間にはr=0.635(n=9)と有意な相関を認めなかった. SPECTによる逆流の有病正診率は95%, 無病正診率は100%であり, Planar法ではそれぞれ75%, 95%であった. 心電図同期SPECTは, 左室逆流性弁膜疾患の定量評価にきわめて有用な方法であり, Planar法に比してより信頼できるものと結論された.
Practice臨床医学：一般
KeywordsSingle photon emission computed tomography, Regurgitant fraction, Stroke volume ratio, Valvular regurgitation, Ventricular volume.
English
TitleQuantitative Evaluation of Left-sided Valvular Regurgitation by Gated Single Photon Emission Computed Tomography
SubtitleOriginal Articles
AuthorsJunichi TAKI, Hisashi BUNKO, Kenichi NAKAJIMA, Ichiro NANBU, Yasushi SHIIRE, Mitsuru TANIGUCHI, Norihisa TONAMI, Kinichi HISADA
Authors(kana)
OrganizationDepartment of Nuclear Medicine, School of Medicine, Kanazawa University
JournalThe Japanese Journal of nuclear medicine
Volume24
Number2
Page137-141
Year/Month1987/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Severity of aortic and mitral regurgitations was quantitatively evaluated using gated single photon emission computed tomography (SPECT). Data were acquired from 36 views over 360 degrees using dual headed cameras after equilibration of 30 mCi of Tc-99m red blood cells. Cardiac cycles were divided into 12 frames. Absolute right and left ventricular end-diastolic and end-systolic volumes were calculated based on the number of boxels within a ventricular border determined by isocount method. The optimal threshold level (OT) for delineating ventricular border was determined by the following equation: OT=0.47・BG + 44.2 (%), where BG is background level expressed as the ratio (%) of background to maximum ventricular count in the reconstructed image. Then the regurgitant fraction (RF) were calculated by following equation: RF=1-(1/SVR), where SVR is stroke volume ratio calculated from left ventricular storke volume devided by right ventricular stroke volume. Planar gated blood pool studies were also performed using slant hole collimator and SVR was calculated using stroke volume image. In 20 patients without valvular regurgitation and/or shunt diseases, RF was 2.3 +- 8.6% (mean +- SD) by SPECT and RF of 20 patients with left-sided valvular diseases was 41.0 +- 15.6% (p<0.001). By SPECT, RF of mild regurgitation (1 to 2 degrees of Sellers classification) was 32.8+- 13.5% (n=8) and significantly higher than control group (p<0.001). RF of 3 degree was significantly higher than mild regurgitant group (49.9 +- 13.5%, n=7). When normal upper limit of RF was determined to be the mean + 2 SD of control group, the sensitivity and specificity for the diagnosis of the presence of regurgitation was 95% and 100% by SPECT and 75 % and 95% by planar study. In conclusion our new method for the evaluation of regurgitant fraction of left-sided valvular disease using SPECT was reliable.
PracticeClinical medicine
KeywordsSingle photon emission computed tomography, Regurgitant fraction, Stroke volume ratio, Valvular regurgitation, Ventricular volume.

【全文PDF】