Japanese
Title201Tl心筋SPECTにおける再分布領域の定量表示マップと血行再建術症例への応用
Subtitle原著
Authors中西文子*, 春日敏夫*, 曽根脩輔**, 小口和浩**, 伊藤敦子**, 横田憲一*, 矢野今朝人*, 伴隆一***
Authors(kana)
Organization*信州大学医学部中央放射線部, **放射線医学教室, ***島津製作所医用技術研究所
Journal核医学
Volume29
Number8
Page971-978
Year/Month1992/8
Article原著
Publisher日本核医学会
Abstract「要旨」負荷心筋タリウムSPECTにおいて再分布領域と固定欠損領域とを判別し, それぞれの領域を定量し, polar mapに表示するコンピュータ処理法を開発した. 局所心筋へのタリウムの分布を最高カウント部に対する相対値で表し, initial%uptake(%Ui)とdelayed%uptake(%Ud)とし, %Ud/%Ui ratioを再分布比(RD-ratio)として数値化した. 短軸断面の各ピクセルでえられた%UiとRD-ratioの値をXY座標上にプロットし, これらを次の4つの直線によって正常領域, 再分布領域, 固定欠損領域に判別した. これらの直線とは, 1. 虚血部の測定からえられた%UiとRD-ratioとの関係を示すY=2.0-0.012X, 2. この直線より-1.5SDだけ平行移動した直線, 3. 虚血と正常との境界値67%を通る直線, 4. 虚血下限値と定めた27.6%を通る直線である. それぞれの領域はpolar map上にカラーで識別され, 相対面積値も表示される. 判別の基準とした直線や値はPTCAの成功例(n=21)での治療前の病巣と, 前回報告した1枝病変例(n=66)および対照群(n=16)での測定結果に基づいて定められた. 本法を別のPTCA成功例(n=15)の術前後において応用し, retrospectiveに検討した. 心筋梗塞の既往のない群では再分布領域の相対面積平均値は, 術前の37.3%から術後の1.3%に減少し, 心筋梗塞の既往のある群では, 再分布領域は術前の40.1%から18.6%に減少した. さらに後者では, 固定欠損領域の面積も9.7%から2.9%に減少した. 本法は従来のpolar mapに加え, 病変部を再分布領域と固定欠損領域とに自動判別し, それぞれの面積を数値化できるためPTCA前後の評価に有用と考えられた.
Practice臨床医学：一般
Keywords201Tl SPECT, Polar map, Redistribution, Myocardial viability, Percutaneous transluminal angioplasty.
English
TitleA New Polar Map to Quantify Reversible Area by Myocardial 201Tl Single Photon Emission Computed Tomography and Clinical Application to Patients before and after Percutaneous Transluminal Coronary Angioplasty
SubtitleOriginal Articles
AuthorsFumiko NAKANISHI*, Toshio KASUGA*, Shusuke SONE*, Kazuhiro OGUCHI*, Atsuko ITO*, Kenichi YOKOTA*, Kesato YANO*, Ryuichi BAN**
Authors(kana)
Organization*Department of Radiology, Shinshu University School of Medicine, **Medical Technology Research Laboratory, Shimadzu Corporation
JournalThe Japanese Journal of nuclear medicine
Volume29
Number8
Page971-978
Year/Month1992/8
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]In the studies of stress 201Tl single photon emission computed tomography, we have developed a computer method to discriminate reversible from irreversible defect, then quantify each area and display the area on the polar map. Initial percent uptake (%Ui) and delayed percent uptake (%Ud) were expressed as percent of the maximum uptake area and were defined as regional myocardial 201Tl uptake in initial and delayed image, respectively. The %Ud/%Ui ratio was defined as redistribution ratio (RD-ratio). The values of %Ui obtained from each pixel of short axis slices were plotted against the values of RD-ratio on XY co-ordinates. In this graphic display, normal area, ischemic viable area and non viable area were separated by the following four lines. A; The straight line (Y=2.0-0.012X) indicating the relationship between %Ui and RD-ratio for the group with ischemic viable myocardium. B; The parallel line to A and shifted to -1.5 SD from A. C; The vertical line at 67.0% level (ischemic upper level). D; The vertical line at 27.6% level (viable lower level). Each area was discriminated by color display and calculated relative area values were displayed on the polar map. Criteria for discriminating each area were derived from the results of ischemic pre-transluminal coronary angioplasty (PTCA) lesions (n=21) in which viability was confirmed by successful PTCA and previous results of 66 cases with single vessel disease and 16 cases of control group. This new computerized technique was applied for evaluation of another group with successful PTCA (n=15). Ischemic viable area decreased from 37.3 to 1.3 percent in patients without prior myocardial infarction and it decreased from 40.1 to 18.6 percent in patients with prior myocardial infarction. Non viable area in patients with prior myocardial infarction decreased from 9.7 to 2.9 percent. In conclusion, this technique may be useful for quantitative assessment of myocardial viability before and after PTCA.
PracticeClinical medicine
Keywords201Tl SPECT, Polar map, Redistribution, Myocardial viability, Percutaneous transluminal angioplasty.

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