| Japanese |
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| Title | Tl-201負荷心筋シンチグラフィによる有痛性および無痛性虚血の評価 |
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| Subtitle | ≪原著≫ |
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| Authors | 滝淳一*, 村守朗*, 中嶋憲一*, 松成一朗*, 分校久志*, 南部一郎*, 谷口充*, 利波紀久*, 久田欣一* |
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| Organization | *金沢大学医学部核医学科 |
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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 | 611-616 |
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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」虚血性心疾患において無痛性虚血, いわゆるsilent ischemiaが虚血のエピソードの大きな部分を占めていることがホルター心電図により明らかになってきている. 自転車エルゴメータによる多段階負荷Tl-201心筋シンチグラフィを用いて, 負荷中に狭心症状または心電図上のST低下を示した虚血性心疾患患者40例を対象として, 狭心症状を有する群と無痛性のST低下群との比較を行った. 25例では無痛性の0.1 mV以上の水平または下降性のST低下を示し(SI群), 15例において狭心症状を認めた(P群). 両群間には年齢, 性別, 心筋梗塞既往歴, 有意冠動脈狭窄数, 耐糖能異常率に差はなかった. SPECT像による視覚判定ではP群, SI群での有再分布率は87%, 56%(p<0.05)とP群で高く, Bull's-eye表示によるwashout analysisでもwashout異常低下の範囲を示すextent scoreはP群で大きかった(37.2±23.6% vs. 19.6±20.8%, p<0.05). 以上より狭心症状を伴う虚血は無症状のものより虚血程度が重い傾向にあり, 狭心症状の発現に虚血程度が関与しているものと考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Ischemic heart disease, Silent ischemia, Tl-201 washout rate, Bull's-eye display, Single photon emission computed tomography (SPECT). |
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| English |
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| Title | Evaluation of Ischemia by Exercise Stress Tl-201 Myocardial SPECT in Silent and Symptomatic Ischemia |
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| Subtitle | - Original Articles - |
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| Authors | Junichi TAKI, Akira MURAMORI, Kenichi NAKAJIMA, Ichiro MATSUNARI, Hisashi BUNKO, Ichiro NANBU, Mitsuru TANIGUCHI, Norihisa TONAMI, Kinichi HISADA |
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| Organization | Department of Nuclear Medicine, Kanazawa 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 | 611-616 |
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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] Forty patients with ischemic heart disease confirmed by coronary arteriography were performed Tl-201 stress myocardial scintigraphy using SPECT. Fifteen patients had anginal attack during exercise Tl-201 myocardial perfusion study (symptomatic group), and 25 patients had horizontal or downsloping ST segment depression more than 0.1 mV without angina (asymptomatic group). The washout maps were derived from circumferential profile analyses of tomographic short-axis slices, and the data were plotted as a bull's eye map. The patient's washout map was compared with the lower limit of normal (mean-2 SD), and the extent and severity scores were calculated. On visual analysis 87% (13/15) of symptomatic patients showed redistribution, while only 56% (14/25) of asymptomatic patients showed redistribution (p<0.05). The extent score was significantly higher in the symptomatic group than in asymptomatic group (37.2 + 23.6 vs.19.6 + 20.8, p<0.05), but severity score was slightly higher in symptomatic group (56.1 + 59.4 vs. 30.0 + 54.8, NS). In conclusion, symptomatic ischemia may be more severe than asymptomatic one and the degree of ischemia may be one of the factors that determine the presence of angina during ischemia. |
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| Practice | Clinical medicine |
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| Keywords | Ischemic heart disease, Silent ischemia, Tl-201 washout rate, Bull's-eye display, Single photon emission computed tomography (SPECT). |
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