| Japanese |
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| Title | 99mTc-PYP心筋シンチにて著明な集積像を認めたstunned myocardiumの1例 |
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| Subtitle | 症例報告 |
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| Authors | 青木俊和*, 西川英郎*, 本康宗信*, 清水雄三*, 福井淳*, 小野直見*, 角田裕*, 小西得司**, 中野赳* |
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| Organization | *山田赤十字病院循環器科, **三重大学医学部第一内科 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 1 |
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| Page | 61-67 |
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| Year/Month | 1993/1 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」症例は71歳女性で, 不安定狭心症のため入院. 入院時心電図上V1-V3でQSパターン, 左室造影で前壁中隔はakinesis, 99mTc-PYP心筋シンチでは前壁・中隔・心尖部にParkey分類III度の著明な集積を認めた. 冠動脈造影ではLAD#6に99%with delayの狭窄を認めるため, 同部位にPTCAを施行, 約3か月後に再狭窄があり再度PTCAを施行した. 1度目のPTCA直後の安静時201Tl心筋シンチでは前壁・中隔心尖部の完全欠損が認められた. 2度目のPTCA後再狭窄は認めず, 約1年後には心尖部の1部を除き壁運動は正常化し, stunned myocardiumと考えられた. また同時期のTlのuptakeも心尖部を除き正常化していた. 本例は, 99mTc-PYP心筋シンチにて著明な集積像を認めたstunned myocardiumの1例と考えられた. 従来, 99mTc-PYP心筋シンチは急性心筋梗塞等の不可逆性の障害心筋に取り込まれるとされており, stunned myocardiumに取り込まれたとする報告はなく, 稀な1例と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Stunned myocardium, 99mTc-pyrophosphate myocardial scintigraphy, 201Tl myocardial SPECT. |
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| English |
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| Title | A Case of Stunned Myocardium with Marked 99mTc-PYP Accumulation |
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| Subtitle | Case Report |
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| Authors | Toshikazu AOKI*, Hideo NISHIKAWA*, Munenobu MOTOYASU*, Yuzo SHIMIZU*, Atsushi FUKUI*, Naomi ONO*, Yutaka KAKUTA*, Tokuji KONISHI**, Takeshi NAKANO** |
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| Authors(kana) | |
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| Organization | *Division of Cardiology, Yamada Red Cross Hospital, **First Department of Internal Medicine, Mie University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 1 |
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| Page | 61-67 |
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| Year/Month | 1993/1 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]A 71-year-old woman with unstable angina was admitted to our department. Upon admission, electrocardiography revealed a QS pattern in Leads V1-V3. Left ventriculography disclosed akinesis of the anterior wall and the septum. Myocardial scintigraphy with 99mTc-pyrophosphate (PYP) revealed marked accumulation (Parkey's grade III) in the anterior wall, septum and apical region. Coronary arteriography revealed stenosis (99% with delay) in the LAD #6. Based on these findings, we performed percutaneous transluminal coronary angioplasty (PTCA) on this patient. About 3 months later, the patient underwent PTCA again because stenosis had recurred. The resting 201Tl myocardial scintigram, taken immediately after the first PTCA, demonstrated complete defects in the anterior wall, septum and apical region. After the second PTCA, no stenosis was observed. About 1 year later, the wall motion returned to normal (except in part of the apical region), suggesting that this was a case of stunned myocardium. On the same occasion, the 201Tl uptake was normal except in the apical region. The present case was regarded as stunned myocardium which demonstrated marked radioactivity accumulation when examined by 99mTc-PYP myocardial scintigraphy. In the past, 99mTc-PYP has been thought to be incorporated into irreversibly impaired myocardium (e. g. , in cases of acute myocardial infarction). The uptake of 99mTc-PYP into stunned myocardium has not been reported before. Thus, this case is rare and noteworthy. |
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| Practice | Clinical medicine |
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| Keywords | Stunned myocardium, 99mTc-pyrophosphate myocardial scintigraphy, 201Tl myocardial SPECT. |
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