| Japanese |
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| Title | 陳旧性心筋梗塞巣viability評価における運動負荷再静注201Tl SPECTの有用性と限界 |
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| Subtitle | 原著 |
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| Authors | 松尾仁司*, 渡辺佐知郎*, 加納素夫*, 森省一郎*, 西田佳雄*, 松原徹夫*, 杉山明*, 松野由起彦*, 小田寛*, 琴尾泰典*, 大橋宏重*, 後藤明**, 川森正喜**, 牧田一成**, 石黒源之*** |
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| Authors(kana) | |
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| Organization | *県立岐阜病院循環器科, 腎臓科, **中央放射線部, ***平野総合病院内科 |
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| Journal | 核医学 |
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| Volume | 29 |
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| Number | 4 |
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| Page | 475-484 |
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| Year/Month | 1992/4 |
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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」心筋viability評価に対する運動負荷再静注201Tlシンチグラフィの有用性と限界を明らかにするため, 陳旧性心筋梗塞血行再建成功例12例(梗塞責任冠動脈が完全閉塞, もしくは亜完全閉塞)を対象に血行再建前シンチグラム所見と血行再建による壁運動変化(ΔWMI)を対比検討した. 負荷後欠損区域53区域は, 4時間後再分布(RD)がある21区域(G1), RDはないが再静注によりfill in(FI)があった11区域(G2A), RD, FIともにない21区域(G2B)に分類できた. G2Aは著明な壁運動の改善を示し, その程度はGlと同等で, 生存心筋と考えられた. G2Bも有意な壁運動改善を示したがその程度はG1, G2Aに比し有意に小であり, 血行再建による壁運動の大幅な改善は期待できないと考えられた(ΔWMS:G1, 0.99±1.08. G2A, 1.05±1.32. G2B, 0.31±0.77. p<0.05 G2B vs. V1, p<0.01 G2B vs. G2A). またG2B 21区域中6区域(29.0%)は著明な壁運動改善を示し, 再静注法を用いても心筋viabilityは過小評価された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Old myocardial infarction, Myocardial viability, Reinjection of 201Tl, Revascularization, Wall motion improvement. |
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| English |
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| Title | The Value and Limitation of Resting 201Tl Reinjection after Stress-Redistribution Imaging for the Assessment of Myocardial Viability : Comparison with Wall Motion Improvement by Revascularization |
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| Subtitle | Original Article |
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| Authors | Hitoshi MATSUO*, Sachiro WATANABE*, Motoo KANO*, Shouichiro MORI*, Yoshio NISHIDA*, Tetsuo MATSUBARA*, Akira SUGIYAMA*, Yukihiko MATSUNO*, Hiroshi ODA*, Yasunori KOTOO*, Hiroshige OOHASHI*, Akira GOTOH**, Masaki KAWAMORI**, Kazunari MAKITA**, Motoyuki ISHIGURO*** |
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| Authors(kana) | |
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| Organization | *Department of Cardiology, Nephrology, **Department of Radiology, Gifu Prefectural Hospital, ***Department of Internal Mediine, Hirano General Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 29 |
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| Number | 4 |
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| Page | 475-484 |
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| Year/Month | 1992/4 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Clinical value and limitation of resting reinjection of small dose of thallium (37 MBq) for the assessment of myocardial viability were evaluated. The results were compared with the degree of wall motion improvement by revascularization to infarcted myocardium supplied by chronic total vessels in 12 patients with old myocardial infarction. Thallium uptake was visually scored and judged as normal, reversible defect (Group 1), new fill in after reinjection (Group 2A), and no fill in even after reinjection (Group 2B). Among 53 segments with initial perfusion abnormality, 21 segments reverted to almost normal, while 32 segments remained abnormal on redistribution images. New fill in after reinjection was observed in 11 segments of 32 segments showing persisting defect on stress and delayed image (37％). Wall motion score index of Group 2A improved significantly higher than Group 2B (p<0.01) and almost equal to Group 1, suggesting the utility of reinjection for the assessment of tissue viability which may be underestimated by conventional imaging. But significant wall motion improvement (>=0.6 mean SD/chords) was observed in 6 segments (29%) of 21 segments showing neither redistribution nor fill in after reinjection. These data indicate that small dose of thallium reinjection may enhance detection of viable but jeopardized myocardium, although some underestimation of viability remained to be resolved. |
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| Practice | Clinical medicine |
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| Keywords | Old myocardial infarction, Myocardial viability, Reinjection of 201Tl, Revascularization, Wall motion improvement. |
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