| Japanese |
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| Title | 急性心筋梗塞症発症1か月後の安静時タリウム心筋SPECT像における梗塞部位逆再分布現象の臨床的意義 |
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| Subtitle | 原著 |
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| Authors | 馬本郁男*, 杉原洋樹*, 原田佳明*, 沢田尚久*, 松室明義*, 松原欣也*, 志賀浩治*, 中川達哉*, 大西和彦*, 中村隆志*, 東秋弘*, 河野義雄*, 勝目紘*, 中川雅夫*, 宮尾賢爾** |
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| Authors(kana) | |
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| Organization | *京都府立医科大学第二内科, **京都第二赤十字病院内科 |
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| Journal | 核医学 |
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| Volume | 28 |
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| Number | 7 |
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| Page | 749-757 |
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| Year/Month | 1991/7 |
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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」安静時タリウム心筋SPECT像における逆再分布現象が急性心筋梗塞症の急性期に認められることは少なくない. しかし, 亜急性期の報告はなく, この時期の安静時逆再分布現象の臨床的意義を検討するため, 初回急性心筋梗塞症37例を対象として発症1か月後に安静時201Tl SPECTを施行し, 初期像と遅延像を比較した. 視覚的に19例 (51%) が固定灌流低下 (Persistent Defect : PD), 18例 (49%) が逆再分布 (reverse Redistribution : r-RD) を示した. 再分布が認められなかったPD群に比しr-RD群は冠状動脈の早期再疎通例が多く, また発症3〜7日目に施行した99mTc-PYP / 201TlCl Dual SPECT像でoverlap現象を多く認めた. r-RD群はPD群に比し急性期のタリウム欠損は軽度で, 1か月後ではより改善する例が多かった. r-RD群ではPD群に比し, 1か月後の梗塞部責任冠血管の狭窄度は軽度であり, 梗塞部位の壁運動異常も軽度であった. Washout Rateはr-RD群が健常部より梗塞部で有意に高値を示した. 以上のことから視覚的に判定した梗塞部逆再分布は梗塞部のWashout Rateが高値を示すために出現し, salvageされた心筋に高頻度に見られる現象であると考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Reverse redistribution, Myocardial viability, 201-Tl SPECT at rest. |
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| English |
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| Title | The Clinical Significance of Reverse Redistribution of Tl-201 SPECT at Rest in the 1st Month after the Onset of Acute Myocardial Infarction |
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| Authors | Ikuo UMAMOTO*, Hiroki SUGIHARA*, Yoshiaki HARADA*, Takahisa SAWADA*, Akiyoshi MATSUMURO*, Kinya MATSUBARA*, Kouji SHIGA*, Tatsuya NAKAGAWA*, Kazuhiko OONISHI*, Takashi NAKAMURA*, Akiyoshi AZUMA*, Yoshio KOHNO*, Hiroshi KATSUME*, Masao NAKAGAWA*, Kenji MIYAO** |
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| Authors(kana) | |
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| Organization | *Second Department of Medicine, Kyoto Prefectural University of Medicine, **Kyoto Second Red Cross Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 28 |
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| Number | 7 |
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| Page | 749-757 |
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| Year/Month | 1991/7 |
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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 pattern of Thallium-201 reverse redistribution (r-RD) at rest has been reported in some patients with acute myocardial infarction (AMI) in the acute phase. But there is no report of this pattern in the later phase. To investigate the significance of Thallium-201 reverse redistribution in the subacute phase, 37 patients with AMI underwent Thallium-201 SPECT at rest a month after the onset. The patients were classified into three groups visually and 19 of 37 patients (51%) showed the persistent defect pattern (Group PD), and the remaining 18 patients (49%) had the reverse redistribution pattern (Group r-RD). None of them had the redistribution pattern. Coronary reflow was earlier and the incidence of the scintigraphic overlap on Dual SPECT image of 99mTc-PYP / 201TlCl in the acute phase was more frequent in Group r-RD than in Group PD. A decrease in thallium defect size of patients with r-RD from the acute phase to one month after the onset represented improvement more significantly than that with PD. Initial %Tl uptake of the infarcted region of Group r-RD was greater than that of Group PD. The degree of stenosis of the infarct-related coronary artery in Group r-RD was less severe than that in Group PD. And corresponding regional wall motion of Group r-RD was less impaired. The Thallium-201 washout in the infarcted region with r-RD was significantly faster than that in the normal region. It is concluded that the r-RD pattern at rest in the 1st month after the onset of AMI may be a sign of viable myocardium. |
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| Practice | Clinical medicine |
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| Keywords | Reverse redistribution, Myocardial viability, 201-Tl SPECT at rest. |
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