| Japanese |
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| Title | 心筋局所におけるThallium-201活性の経時的変化観察による心筋虚血の評価 |
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| Subtitle | 原著 |
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| Authors | 勝木孝明*, 飯野智也*, 豊崎信雄*, 夏目隆史*, 柳沼淑夫*, 細田瑳一*, 川村義文**, 三沢一郎**, 古瀬信** |
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| Organization | *自治医科大学循環器内科, **放射線科 |
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| Journal | 核医学 |
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| Volume | 24 |
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| Number | 10 |
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| Page | 1547-1556 |
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| Year/Month | 1987/10 |
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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」 冠動脈造影を行った虚血性心疾患51例に対して, Tl-201 SPECT短軸像の同心円表示法を用いて心筋局所の経時的Tl減衰曲線を検討した. 同心円表示上で関心領域を設定し, その平均カウントの経時変化を観察すると, 心筋虚血部は, 正常部に対して上向き凸のカーブを描き, かつ2時間後までのTl減衰がその後の減衰よりも明らかに緩やかであった. このことから, 直後〜2時間, 2〜4時間のカウント変化の比 (DR) と直後から2時間の最大カウントに対する時間当たり減衰率 (%decay) を指標とした. DRは正常部1.70±0.68, 虚血部0.39±0.45 (p<0.001) で, %decayは正常部-12.8±4.2, 虚血部-3.1±3.6 (p<0.001) であった. この方法により心筋虚血部は, DR<0.8かつ%decay>-8.0を基準として感受性92.3%, 特異性93.0%で正常部と区別できた. 以上, 経時的局所心筋Tlの減衰曲線の解析により, 従来検出不可能であった虚血部位の推定が可能となった. |
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| Practice | 臨床医学：一般 |
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| Keywords | Emission computed tomography, Tl-201 exercise myocardial image, Myocardial ischemia, Time-activity curve of Tl-201, Polar representation |
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| English |
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| Title | Evaluation of Ischemic Myocardium with Regional Time-activity Curve of Tl-201 |
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| Subtitle | Original Articles |
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| Authors | Taka'aki KATSUKI*, Tomoya IINO*, Nobuo TOYOSAKI*, Takashi NATSUME*, Toshio YAGINUMA*, Saichi HOSODA*, Yoshifumi KAWAMURA**, Ichiro MISAWA**, Makoto FURUSE** |
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| Authors(kana) | |
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| Organization | *Department of Cardiology, **Department of Radiology, Jichi Medical School |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 24 |
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| Number | 10 |
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| Page | 1547-1556 |
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| Year/Month | 1987/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | The present study was designed to elucidate the characteristic time-activity course of ischemic areas and the value of new parameter, decay ratio (DR) , comparing with washout ratio and visual diagnosis using the polar representations of Tl-201 rotational myocardial scintigraphy (polar map) . We analyzed polar maps of 51 patients (pts) with ischemic heart diseases who underwent coronary arteriography (CAG) . An image immediately after exercise, and serial delayed images after 120 and 240 min were acquired. Additional images were acquired 30, 60 and 180 min after exercise in 14 pts. Regions of interest in the polar maps corresponding to normal or possible ischemic myocardium on the basis of CAG findings were selected and their average counts (Ct) over 72+-32 areas were plotted against acquisition time. Obtained time-activity curve represented upper concaved decline and slow Tl washout in ischemic lesions. From these observation, two parameters were calculated ; 1) %decay (%D) =average change of Tl-201 uptake between the immediate and 120 min, and 2) Decay Ratio (DR) = (Ct0min-Ct120min) / (Ct120min-Ct240min) . %Din 43 normal segments, which were acquired 6 or 4 times, was significantly different from that in 25 ischemic segments (-12.7+-6.2% vs. -3.4+-3.2%, p<0.001) . DR were 1.57+-0.68 in 86 normal segments and 0.40+-0.42 in 45 ischemic segments (significantly different, p<0.001) . In contrast to diagnostic sensitivity 57.8% and specificity 95.3% of washout ratio, combination of these parameters distinguished normal from ischemic segments with specificity 93.0% and sensitivity 92.3%. Analysis of the regional decline curve of Tl activity using polar map was valuable in detection of the diseased coronary segments especially in pts with multivessel disease. |
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| Practice | Clinical medicine |
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| Keywords | Emission computed tomography, Tl-201 exercise myocardial image, Myocardial ischemia, Time-activity curve of Tl-201, Polar representation |
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