| Japanese |
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| Title | 安静時および運動負荷201Tl-SPECT・心プールSPECT法による経皮的冠血管形成術後の冠血流改善と hibernation の検出 |
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| Subtitle | 原著 |
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| Authors | 橋本暁佳*, 中田智明*, 土橋和文*, 遠藤明太*, 高橋尚子*, 長尾和彦*, 田中繁道*, 津田隆俊**, 久保田昌宏**, 飯村攻* |
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| Authors(kana) | |
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| Organization | *札幌医科大学第二内科, **札幌医科大学放射線科 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 2 |
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| Page | 135-144 |
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| Year/Month | 1993/2 |
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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」経皮的冠血管形成術(PTCA)を狭心症(AP)21例, 心筋梗塞後狭心症(MI)21例の63病変に対し計47回施行し, 201Tl心筋灌流と局所壁運動の改善を運動負荷および安静時201Tl心筋心SPECT, RIプール位相解析・SPECT法にて解析した. PTCA前陽性率は症状, ECG変化(38〜60%)に比し, 201Tl再分布所見が高値(87%)で, PTCA後201Tl冠灌流の改善を88%の症例で認め, 201TlスコアもAP, MI両群で有意に改善した. 左室駆出分画と最大拡張速度はMI群で有意に上昇. 心プールSPECT上 asynergy は27例92領域中47領域(51%)で改善し, 局所壁運動スコアもAP, MI両群で有意に改善. 一方, asynergy 非改善領域の93%は梗塞部位に一致していた. 以上, 運動負荷201Tl心筋SPECT, 心プール位相解析・SPECT法は心筋虚血改善に伴う拡張障害および局所壁運動異常の改善を評価しえ, 非侵襲的な myocardial hibernation の同定に有用と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Exercise-stress thallium scintigraphy, Gated blood pool tomography, Percutaneous transluminal coronary angioplasty, Cardiac function, Myocardial hibernation |
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| English |
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| Title | Assessment of Myocardial Perfusion Abnormality and Hibernating Myocardium by Gated Blood Pool and Exercise-Stress Thallium Tomographies after Successful Coronary Angioplasty |
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| Subtitle | Summary |
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| Authors | Akiyoshi HASHIMOTO*, Tomoaki NAKATA*, Kazufumi TSUCHIHASHI*, Akita ENDOH*, Naoko TAKAHASHI*, Kazuhiko NAGAO*, Shigemichi TANAKA*, Takatoshi TSUDA**, Masahiro KUBOTA**, Osamu IIMURA* |
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| Authors(kana) | |
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| Organization | *Second Department of Internal Medicine, **Department of Radiology, Sapporo Medical College |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 2 |
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| Page | 135-144 |
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| Year/Month | 1993/2 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Cardiac function and myocardial perfusion were assessed by exercise-stress thallium SPECT and resting gated blood pool SPECT techniques before and after 47 successful coronary angioplasties. Thallium perfusion was analyzed visually and quantitatively in stress and resting studies. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) were calculated and regional wall motion was scored by amplitude and phase images in radionuclide planar and tomographic imagings. The thallium redistribution in delayed or resting SPECTs was more sensitive (87%) for detecting myocardial ischemia compared to symptoms (36%) and ECG changes (60%). An exercise capacity, LVEF, PFR, and the scores of perfusion and regional wall motion were improved significantly after coronary angioplasty. Stree thallium and gated blood pool SPECTs showed the improvements of myocardial perfusion in 159 (79%) of 201 segments and regional wall motion in 47 (51%) of 92 segments, respectively. These results suggest that the combined use of stress thallium SPECT, gated blood pool planar and SPECT techniques can contribute not only to the assessment of the efficacy of coronary angioplasty but also to detecting the mismatching of myocardial perfusion and contraction ("myocardial hibernation") in infarct-related myocardial lesions. |
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| Practice | Clinical medicine |
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| Keywords | Exercise-stress thallium scintigraphy, Gated blood pool tomography, Percutaneous transluminal coronary angioplasty, Cardiac function, Myocardial hibernation |
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