Japanese |
Title | 123I-MIBG (metaiodobenzylguanidine) を用いた急性心筋梗塞における経時的観察 |
Subtitle | 《原著》 |
Authors | 西村恒彦*, 植原敏勇*, 岡尚嗣*, 汲田伸一郎*, 三谷勇雄*, 与小田一郎*, 林田孝平*, 土師一夫**, 大江透** |
Authors(kana) | |
Organization | *国立循環器病センター放診部, **内科 |
Journal | 核医学 |
Volume | 27 |
Number | 7 |
Page | 709-718 |
Year/Month | 1990/7 |
Article | 原著 |
Publisher | 日本核医学会 |
Abstract | 「要旨」123I-MIBGは心筋交感神経終末に摂取され, 交感神経機能の画像化が行えるとされる. そこで123I-MIBGおよび201TlCl(ともに111 MBq(3 mCi)静注)による同時収集心筋SPECTを, 急性期(平均10±2日)および慢性期(平均86±10日)に施行, 本法を用いて非観血的に心筋交感神経機能の喪失, 回復過程が画像化できるか検討した. さらに, 陳旧性心筋梗塞にて心室性頻拍を有する4症例についても同様の方法にて施行した. 心筋梗塞急性期では, 123I-MIBGの欠損は201TlClに比して大きく, 7例にて201TlClの血流改善とともに123I-MIBGの欠損は慢性期に縮小した. 残り7例では201TlCl, 123I-MIBGともに著明な欠損の改善はなかった. 心室性頻拍を有する4例では, 陳旧期でも123I-MIBGは, 201TlClに比し欠損が大きかった. したがって, 123I-MIBGは, 急性期において除神経された領域(Denervated but viable muscle)が, 回復する過程を画像化でき, また心室性頻拍との関連で評価できる可能性が示唆された. |
Practice | 臨床医学:一般 |
Keywords | 123I-MIBG, 201TlCl, Acute myocardial infarction, Ventricular tachycardia, myocardial SPECT. |
English |
Title | Serial Assessment of Denervated but Viable Myocardium Following Acute Myocardial Infarction by Using 123I-MIBG and 201TlCl Myocardial SPECT |
Subtitle | - Original Articles - |
Authors | Tsunehiko NISHIMURA, Toshiisa UEHARA, Hisashi OKA, Shin-ichiro KUMITA, Isao MITANI, Ichiro YOKOTA, Kohei HAYASHIDA, Kazuo HAZE, Tohru OHE |
Authors(kana) | |
Organization | Department of Radiology and Cardiology, National Cardiovascular Center |
Journal | The Japanese Journal of nuclear medicine |
Volume | 27 |
Number | 7 |
Page | 709-718 |
Year/Month | 1990/7 |
Article | Original article |
Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
Abstract | 123I-MIBG is taken up by sympathetic nerve ending and provides a scintigraphic image of myocardial sympathetic innervation. We investigated the scintigraphic detection of denervated but viable myocardium following acute myocardial infarction by serial 123I-MIBG and 201TlCl myocardial SPECT. Fourteen patients were studied at acute (10+-2 days) and chronic stage (86+-10 days). Simultaneous dual SPECT was carried out after IV administration of 111 MBq (3 mCi) of 201TlCl and 123I-MIBG. The defect size of 123I-MIBG and 201TlCl were compared visually by using Bull’s eye display generated from each myocardial SPECT. In all patients, 123I-MIBG defect showed larger compared to 201TlCl defect at acute stage, which suggest the existence of denervated but viable myocardium. Of these patients, seven showed significant improvement of both defects, though 123I-MIBG defect showed slightly larger compared to 201TlCl defect, even at chronic stage. These patients had exercise induced thallium transient defect at infarcted area. The remaining 7 patients had no improvement of both defects at chronic stage, which suggest the complete scar at infarcted area. In addition to above study, 4 patients of old myocardial infarction demonstrated larger 123I-MIBG defect compared to 201TlCl defect even at old stage, which thought to be pathogenesis of ventricular tachycardia. In conclusion, 123I-MIBG could evaluate sympathetic denervation and reinnervation noninvasively in the patients with acute myocardial infarction. |
Practice | Clinical medicine |
Keywords | 123I-MIBG, 201TlCl, Acute myocardial infarction, Ventricular tachycardia, myocardial SPECT. |