| Japanese |
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| Title | 心疾患における201Tl肺集積の血行動態的意義 |
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| Subtitle | ≪原著≫ |
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| Authors | 藤井忠重*, 金井久容*, 田中正雄*, 広瀬芳樹*, 木下修*, 河野純*, 平山二郎*, 本郷実*, 山田博美*, 大久保信一*, 半田健次郎*, 矢野今朝人** |
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| Organization | *信州大学医学部第一内科, **中央放射線部 |
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| Journal | 核医学 |
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| Volume | 26 |
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| Number | 5 |
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| Page | 601-610 |
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| Year/Month | 1989/5 |
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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」各種心疾患244例に201Tl心筋シンチグラフィを実施し, 201Tl肺集積の臨床的意義を多角的に検討した. 201Tl肺集積を視覚的に4段階に分類し, 臨床所見との関係を検討した. さらに全肺摂取率L/Tを含む4種類の半定量的肺集積度を算出し, 57例では肺動脈楔入圧(PCW)や心拍出量(CO)などとの関係を, また, 160例では臨床所見との関係を検討した. 半定量的肺集積度はPCWとは正の, COおよびCIとは負の相関を示し, なかでもL/Tが最も良好な相関を示した. すなわち, L/TはCO(r=-0.53), CI(r=-0.45)およびPCW(r=0.65)とそれぞれ相関し, PCWとの相関が最も良好であった. 201Tl肺集積はL/TやPCWが高値の症例, NYHA 3・4度や左心不全(+)の症例で高度であった. 201Tl肺集積は左心不全・肺うっ血を診断するうえに役立ち, 肺集積度の評価にはルーチン法として視覚的肺集積度が利用でき, また, 半定量的評価にはL/Tが有用である. |
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| Practice | 臨床医学：一般 |
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| Keywords | Thallium-201, Myocardial scintigraphy, Diffuse lung uptake, Lung uptake ratio, Hemodynamic significance. |
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| English |
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| Title | Hemodynamic Significance of Diffuse Lung Uptake of 201Tl in Heart Diseases |
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| Subtitle | - Original Articles - |
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| Authors | Tadashige FUJII*, Hisakata KANAI*, Masao TANAKA*, Yoshiki HIROSE*, Osamu KINOSHITA*, Jun KONO*, Jiro HIRAYAMA*, Minoru HONGO*, Hiromi YAMADA*, Shinichi OKUBO*, Kenjiro HANDA*, Kesato YANO** |
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| Authors(kana) | |
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| Organization | *The First Department of Internal Medicine, **Division of Radiology, Shinshu University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 26 |
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| Number | 5 |
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| Page | 601-610 |
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| Year/Month | 1989/5 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Clinical significance of diffuse lung uptake of 201Tl was studied in 244 cases of various heart diseases. The grade of lung uptake of 201Tl was assessed by total lung uptake ratio (L/T), maximal lung uptake ratio (Max/T), lung to myocardium or mediastinum counts ratio (M/H or M/Med) and visual grade. L/T,Max/T, M/H and M/Med were directly correlated with pulmonary arterial pressure (PCW), and inversely correlated with cardiac output (CO) and cardiac index (CI). Among them, L/T was the best index to assess PCW, that was correlated with PCW (r=0.65), CO (r=-0.53) and CI (r=-0.45). The visual grade of 201Tl lung uptake was correlated with L/T, and the increased lung uptake was associated with a higher PCW and a lower CO as well as a lower CI. Diffuse increased lung uptake of 201Tl was observed in 29 of 41 cases (70.7%) with myocardial infarction, 25 of 29 cases (86.2%) with mitral valvular diseases and g of 10 cases (90.0%) with combined valvular diseases, in addition, in most cases with left heart failure and cases of NYHA 3 and 4, but that was not rarely observed in cases of NYHA 2 and without left heart failure. In heart diseases, 201Tl myocardial scintigraphy seems to be valuable for detection of left heart failure including pulmonary congestion and interstitial pulmonary edema. Total lung uptake ratio (L/T) may be useful for estimation of PCW, and the visual grade of 201Tl lung uptake may be applicable as routine index for grading of lung uptake of 201Tl. |
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| Practice | Clinical medicine |
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| Keywords | Thallium-201, Myocardial scintigraphy, Diffuse lung uptake, Lung uptake ratio, Hemodynamic significance. |
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