| Japanese |
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| Title | 心筋梗塞後心室瘤症例の核医学診断と左室瘤切除後左室機能の術前予測の試み - 心拍同期心プール断層法による - |
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| Subtitle | 原著 |
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| Authors | 津田隆俊*, 久保田昌宏*, 中田智明**, 遠藤明太**, 熊岡構市*, 田中繁道**, 松崎智哉***, 飯村攻**, 森田和夫* |
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| Authors(kana) | |
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| Organization | *札幌医科大学放射線科, **第二内科, ***第二外科 |
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| Journal | 核医学 |
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| Volume | 28 |
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| Number | 6 |
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| Page | 617-627 |
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| Year/Month | 1991/6 |
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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」左室造影 LVG : left ventriculography) にて収縮拡張期を通じて左室に限局した瘤状突出を認める心室瘤群 (VA (+) 群) 35例, 左前下行枝1枝病変で心室瘤のない心筋梗塞症例群 (VA (-) 群) 14例, および心疾患を有しない正常群 (N群) 15例を対象として, 心室瘤に伴うAsynergy, Asynchronyの検出, およびその範囲の同定に関する心拍同期心プール断層法の精度を検討した. さらに, LVG上で, 左室心尖部に限局した心室瘤で, 瘤切除術を施行した9例を対象に術後心機能の予測を試みた. 方法は, 心拍同期心プール断層像をその位相解析像から左室収縮部と非収縮部とに分け, 左室長軸の長さと面積とからArea-Length法により各部位の体積を算出し, 予測左室拡張末期容積と各部の容積値と術前の左室駆出率 (LVEF : left ventricular ejection fraction) より左室残存収縮部のLVEFを算出した. 心拍同期心プール断層法の心室瘤診断精度は, Sensitivity 100%, Specificity 78.6%, Accuracy 93.9%であった. 本法は心拍同期心プールplanar法と比べて, 心室瘤に伴う高度のAsynergy, Asynchronyの検出, 範囲の同定に優れていた. また, 左室瘤切除症例9例の術後LVEFは, 本法による術前予測心機能と良好な相関 (y = 1.09x - 4.37, r = 0.87, p < 0.01) を示した. 心拍同期心プール断層法は, 心筋梗塞後心室瘤の正確な検出に加え, 切除後左室機能を非観血的に予測する方法としても簡便でかつ臨床的に有用な方法と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Left ventricular aneurysm, ECG gated blood pool SPECT. |
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| English |
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| Title | Scintigraphic Diagnosis of Postinfarction Left Ventricular Aneurysm and the Prediction of the Residual Left Ventricular Function After Aneurysmectomy Using ECG Gated Blood Pool SPECT |
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| Subtitle | Original Articles |
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| Authors | Takatoshi TSUDA*, Masahiro KUBOTA*, Tomoaki NAKATA**, Akita ENDOH**, Kouichi KUMAOKA*, Shigemichi TANAKA**, Tomoya MATSUZAKI***, Osamu IIMURA**, Kazuo MORITA* |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Second Department of Internal Medicine, ***Second Department of Surgery, Sapporo Medical College |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 28 |
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| Number | 6 |
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| Page | 617-627 |
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| Year/Month | 1991/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] The diagnostic accuracy of ECG gated blood pool SPECT (blood pool SPECT) for detecting and quantifying postinfarction left ventricular aneurysm (LVA) was assessed in 49 patients with myocardial infarction and 15 control subjects. LVA, which was detected in 35 of 49 patients, was defined as a regional protrusion through a cardiac cycle in contrast ventriculography and as a non-contracting segment with a markedly delayed phase angle in the tomographic functional images derived from phase analysis. The blood pool SPECT technique showed a high sensitivity (100%), specificity (78.6%) and accuracy (93.3%) for detecting LVA and was very useful for precisely determining LVA location and sizing contractile and non-contractile volume of left ventricle in patients with LVA. Furthermore, left ventricular ejection fraction (LVEF) after the excision of LVA was predicted using preoperative pool SPECT images in 9 patients. The predicted LVEF was closely correlated with the measured LVEF after the operation (y = 1.09x - 4.37, r = 0.87, p < 0.01). Thus, gated blood pool SPECT can be a useful non-invasive technique not only for detecting and quantifying left ventricular aneurysm but also for predicting a residual left ventricular function after aneurysmectomy. |
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| Practice | Clinical medicine |
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| Keywords | Left ventricular aneurysm, ECG gated blood pool SPECT. |
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