Japanese
TitleI-123 Metaiodobenzylguanidine (MIBG) 心筋像による心筋症の交感神経局所機能の評価
Subtitle研究速報
Authors田中健*, 相澤忠範*, 加藤和三*, 中野元*, 五十嵐正樹*, 上野孝志*, 広沢弘七郎**, 日下部きよ子***
Authors(kana)
Organization*心臓血管研究所, **東京女子医科大学心臓血圧研究所, ***放射線科
Journal核医学
Volume26
Number2
Page257-261
Year/Month1989/2
Article報告
Publisher日本核医学会
Abstract「要旨」 I-123 Metaiodobenzylguanidine(MIBG)とTl-201(Tl)の二核種同時投与同時収集法によって心筋症のMIBG心筋SPECT像を得た. 定最評価法としてMIBG像およびTl像の最高カウント部を100としdual modeのための散乱成分などを50%としてカットオフして関心部位におけるMIBGとTlの比(M/T比)を求めた. 心不全の既往があるNYHA I度の心筋症5例の安静時像のM/T比は0.8〜1.20の範囲にあった. 4時間後MIBG像の下側壁に広範な欠損を認め, この部位における交感神経機能異常が示唆された. 拡張型心筋症2例では心尖部中隔のM/T比は0.7, 0.75と低下を示し, この部位におけるノルエピネフリンの涸渇が推定された. 3例では心基部中隔のM/T比は1.7, 1.6, 1.7と上昇を示した. 今回の成績はMIBG像による心筋内ノルエピネフリン分布評価(交感神経局所機能評価)の可能性を示したものである. しかし二核種によるバックグラウンド増加や肺内MIBG摂取増加の問題があるため定最評価法に関してはさらに検討が必要と考えられた.
Practice臨床医学：一般
KeywordsI-123 Metaiodobenzylguanidine (I-123 MIBG), Myocardial sympathetic neuronal images, Dual energy SPECT, Cardiomyopathy
English
TitleEstimation of Regional Myocardial Sympathetic Neuronal Function with I-123 Metaiodobenzylguanidine (MIBG) Myocardial Images in Patients with Cardiomyopathy
Subtitle
AuthorsTakeshi TANAKA, Tadanori AIZAWA, Kazuzo KATO, Hajime NAKANO, Masaki IGARASHI, Takashi UENO, Koshichiro HIROSAWA, Kiyoko KUSAKABE
Authors(kana)
OrganizationCardiovascular Institute, Tokyo Women's Medical College
JournalThe Japanese Journal of nuclear medicine
Volume26
Number2
Page257-261
Year/Month1989/2
ArticleReport
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] I-123 Metaiodobenzylguanidine (MIBG) is taken up by myocardial sympathetic neuronal endings. Sympathetic neuronal function in 10 patients with cardiomyopathy under stable state were studied by using MIBG and Tl-201 (Tl) SPECT images with 50% cut off level. For myocardial imaging MIBG and Tl were simultaneously injected and collected (dual injection and dual collection mode; Dd mode). Four hours delayed images were also collected. Three types of abnormal findings were noted in MIBG images in combination with Tl images. 1) Enhancement of regional MIBG washout with otherwise normal MIBG and Tl uptake in infero-lateral wall were noted in 5 patients with history of congestive heart failure (Pathophysiologically acceleration of regional sympathetic neuronal function was suspected. Mean washout ratio is 63+-7% vs. 45+-10% in normal region). 2) In 3 patients with dilated cardiomyopathy increase of MIBG/Tl (M/T) ratio was noted in basal septal wall (Sympathetic neuronal function is abnormally accelerated in the region with depressed coronary perfusion, Exaltation of regional sympathetic neuronal function was suspected. Mean M/T ratio is 1.6. Tentative normal range is from 0.8 to 1.20). 3) In 2 patients with dilated cardiomyopathy under severe congestive heart failure defects of MIBG uptake with normal Tl uptake were noted (Sympathetic neuronal function was depleted in spite of normal coronary perfusion. Depletion of myocardial catecolamine was suspected. M/T ratio is 0.75 and 0.7 respectively). Heterogeneous abnormality of sympathetic neuronal function was noted in MIBG images. This findings corresponded to report about heterogeneous myocardial catecholamine concentrations in hearts of recipients of transplantation. MIBG-images is expected to be useful for estimation of sympathetic neuronal function. For this purpose the combination of I-123 MIBG and Tl-201 dual injection and dual collection mode (Dd mode) is useful.
PracticeClinical medicine
KeywordsI-123 Metaiodobenzylguanidine (I-123 MIBG), Myocardial sympathetic neuronal images, Dual energy SPECT, Cardiomyopathy

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