Japanese
Title201Tl心筋SPECTを用いた展開図法による心筋梗塞サイズの定量評価
Subtitle原著
Authors久保田昌宏*
Authors(kana)
Organization*札幌医科大学放射線医学講座
Journal核医学
Volume29
Number3
Page333-346
Year/Month1992/3
Article原著
Publisher日本核医学会
Abstract「要旨」以前開発した201Tl SPECTを用いた心筋展開図法による心筋梗塞範囲算出の定量性およびその臨床的有用性に関する検討を行った. ファントムによる基礎的検討では, 多断面像より算出した欠損面積と比較して, 心筋展開図法で算出した欠損面積は過大評価する傾向はあるが, 良好な相関を認めた(y=1.941+2.292x, r=0.971, p<0.001). 99mTc-SPECT像からの梗塞容積はその辺縁を決定し算出した. 実測値に最も近い容積を示す至適カットオフ値は55%であった. さらに, 右室梗塞の合併のない急性心筋梗塞症14例のCK-MB総遊出量と核医学的手法で求めた梗塞量とを比較した結果, 展開図法がCK-MB総遊出量と最も高い相関(r=0.897, p<0.001)を示した. 展開図法は核医学的梗塞量の測定法として, 臨床的には簡便で信頼性の高い方法と考えられた.
Practice臨床医学：一般
KeywordsMyocardial infarction, Quantitative analysis, 201Tl myocardial SPECT, Unfolded map method, Bull's eye method, 99mTc pyrophosphate SPECT.
English
TitleQuantitative Assessment of the Infarct Size with the Unfolded Map Method of 201Tl Myocardial SPECT in Patient with Acute Myocardial Infarction
SubtitleOriginal Articles
AuthorsMasahiro KUBOTA
Authors(kana)
OrganizationDepartment of Radiology, Sapporo Medical College
JournalThe Japanese Journal of nuclear medicine
Volume29
Number3
Page333-346
Year/Month1992/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The unfolded map method of 201Tl single photon emission computed tomography (SPECT) was evaluated as to the ability to quantify and the clinical reliability in estimation of infarct size. At first, the following results were obtained in basic experiments using thoracic phantom: 1) the defect area estimated by the unfolded map method was well correlated with the real defect area in spite of overestimation of the defect area, when the defect area was determined by an isocount method (below 80% of maximum count) (y=1.941+2.292x, r=0.971, p<0.001); 2) the defect volume estimated by short-axis images of 201Tl SPECT was closely correlated with real defect volume in spite of overestimation of defect volume (y=0.762+2.156x, r=0.982, p<0.001); 3) when the defect area was estimated by devision of the defect volume by the mean myocardial compartment thickness, it was closely correlated with real defect area (y=0.946+1.232x, r=0.990, p<0.001); 4) when the volume was calculated from the summation of voxels in the regions districted by isocount threshold level at each section of the 99mTc SPECT, the optimal isocount threshold level (percentage to maximum count) was 55%. In addition, the clinical reliability of the unfolded map method as infarct sizing was evaluated in 26 patients with acute myocardial infarction by comparing it with enzymatic method, Bull's eye method, and 99mTc pyrophosphate (PYP) SPECT method. In 14 first attack cases of patient without right ventricular infarction, infarct area (IA) of the unfolded map method correlated most closely with the accumulated creatine kinase MB isoenzyme release (CK-MBr) (r=0.897), compared with the extent score (ES) (r=0.853) and the severity score (SS) (r=0.871) of Bull's eye method and the infarct volume (IV) (r=0.595) of 99mTc PYP SPECT. In conclusion, although the unfolded map method of 201Tl SPECT has the tendency which overestimate infarct size, it is accurate and clinically reliable method in estimating infarct size.
PracticeClinical medicine
KeywordsMyocardial infarction, Quantitative analysis, 201Tl myocardial SPECT, Unfolded map method, Bull's eye method, 99mTc pyrophosphate SPECT.

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