Japanese
TitleC15O2ガス持続吸入平衡時法による局所心筋血流量の測定 - 特に肥大型心筋症における検討 -
Subtitle原著
Authors加賀谷秋彦*, 吉田勝哉*, 遠藤真広***, 氷見寿治*, 庭山博行*, 増田善昭*, 有水昇**, 稲垣義明*
Authors(kana)
Organization*千葉大学医学部第三内科, **放射線科, ***放射線医学総合研究所臨床研究部
Journal核医学
Volume30
Number1
Page1-12
Year/Month1993/1
Article原著
Publisher日本核医学会
Abstract「要旨」脳においてすでに使用されているC15O2ガス持続吸入平衡時法により, 健常4例および各種心疾患39例(虚血性心疾患16例, 肥大型心筋症20例, 拡張型心筋症3例)の心筋血流の画像化を行った. さらに, 局所脳血流量定量と同様な方法により, 部分容積効果が無視可能な心筋壁厚を持つ肥大型心筋症14例の局所心筋血流量の定量も行った. C15O2ガス吸入によるH2 15Oの分布画像から, C15Oガス吸入によるblood pool画像を差し引くことにより心筋血流画像が得られた. その画像は健常例では均一な馬蹄形を呈し, 梗塞例では塞梗部位の集積低下を示した. また, 肥大型心筋症では局所的に肥大した心筋を呈し, 拡張型心筋症では全体的に不規則斑状な集積が見られた. 局所心筋血流量定量に関して, 動脈入力データを画像上の左心房から得ることにより, 一切の血管確保を必要とせず, 心腔内から心筋へのもれこみの補正も含めた局所心筋血流量の定量が非侵襲的に可能であった. 対象14例から求めた局所心筋血流量は平均72.6±28.7 ml/min/100gであった. 6例(18関心領域)について, すでに報告している13NH3によるfirst pass法から求めた局所心筋血流量の値と比較したところ, よい相関を示した. 以上より, C15O2ガス持続吸入平衡時法は非侵襲的な心筋血流の画像診断として有用であり, 部分容積効果の影響のない肥大型心筋症の局所心筋血流量定量も可能である.
Practice臨床医学:一般
KeywordsC15O2 continuous inhalation method, Regional myocardial blood flow, Steady-state theory, Hypertrophic cardiomyopathy.
English
TitleQuantitation of Regional Myocardial Blood Flow Using Continuous Inhalation of C15O2 and Positron Emission Tomography
SubtitleOriginal Articles
AuthorsAkihiko KAGAYA*, Katsuya YOSHIDA*, Masahiro ENDO***, Toshiharu HIMI*, Hiroyuki NIWAYAMA*, Yoshiaki MASUDA*, Noboru ARIMIZU**, Yoshiaki INAGAKI*
Authors(kana)
Organization*Third Department of Internal Medicine, **Department of Radiology, Chiba University School of Medicine, ***Division of Clinical Research, National Institute of Radiological Sciences
JournalThe Japanese Journal of nuclear medicine
Volume30
Number1
Page1-12
Year/Month1993/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]A C15O2 continuous inhalation and a steady-state theory using positron emission tomography (PET) have been used to quantitate regional cerebral blood flow. We extended this method for quantitative regional myocardial blood flow (RMBF) measurement. Forty-three patients, involving 4 normal volunteers, 16 patients with coronary heart disease (CHD), 20 patients with hypertrophic cardiomyopathy (HCM), and 3 patients with dilated cardiomyopathy (DCM), were studied. 6 min-scan was recorded in the steady-state condition during C15O2 continuous inhalation. A C15O inhalation scan was required to obtain the blood pool image. The subtracted image showed myocardial perfusion image. These images demonstrated homogeneous accumulation in normal volunteers. Reduced accumulation were detected in patients with myocardial Infarction. Hypertrophied myocardium was demonstrated in patients with HCM. Diffuse heterogeneous accumulation was demonstrated in patients with DCM. Fourteen patients with HCM, whose left ventricular myocardial thicknesses were more than 20 mm, were selected for the RMBF measurement to minimize errors due to the partial volume effect. The arterial blood activity was measured by assigning a region of interest to the left atrial cavity on PET images. RMBF was calculated using the steady-state theory. Calculated flow values ranged from 21.2 to 152.6 ml/min/100 g. The good correlation was obtained between RMBF using 13NH3 first pass method and RMBF using gas inhalation method in six patients. These results indicate that C15O2 PET has the potential capability for the noninvasive quantitation of RMBF.
PracticeClinical medicine
KeywordsC15O2 continuous inhalation method, Regional myocardial blood flow, Steady-state theory, Hypertrophic cardiomyopathy.

【全文PDF】