| Japanese |
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| Title | 左前下行枝中間部病変により201Tl心筋SPECTに生じる虚血域の特徴 |
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| Subtitle | 原著 |
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| Authors | 田中健*, 相澤忠範*, 加藤和三*, 小笠原憲*, 桐ケ谷肇*, 佐藤宏*, 岡本淳*, 細井宏益* |
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| Authors(kana) | |
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| Organization | *心臓血管研究所 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 3 |
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| Page | 249-255 |
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| Year/Month | 1993/3 |
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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」 201Tl心筋断層像に前下行枝中間部病変によって生じた虚血域の特徴を43例で検討した. 心基部断層像の虚血域右縁は12時を0度として時計方向に(+)として平均-36±17度で左縁は-128±75度であった. -120度以下の症例は28例であった. 心基部下壁が前下行枝よりの中隔枝によって灌流されている例が高頻度で認められた. 6例では責任冠動脈が第一対角枝を含み心尖部側壁に虚血を, 12例では責任冠動脈が第一対角枝を含まなかったが, 第二対角枝を含み, 心尖部側壁に虚血を認めた. 虚血域右縁が前壁正中部に達する断層像は, 前者で3.2±1.4枚目, 後者で5.2±1.8枚目であった(p<0.01). 10例では責任冠動脈が大きい第一対角枝を含まず, 虚血域右縁は中隔にとどまっていた. 残り15例では大きくない第一対角枝を含まず, 第二対角枝が明確に指摘できなかったが, 8例では心尖部側壁の虚血が認められた. これより心尖部側壁の虚血は前下行枝病変に対角枝が含まれていることを示唆する所見と考えられた. 201Tl心筋像に生じた虚血域より, 前下行枝中間部病変の局所解剖の推定が可能と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | 201Tl SPECT, Left anterior descending artery, Midportion lesion, Diagonal branch, Dominancy |
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| English |
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| Title | Scintigraphic Appearance in Stress 201Tl Myocardial SPECT of Midportion Lesion in Left Anterior Descending Artery |
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| Subtitle | Original Articles |
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| Authors | Takeshi TANAKA*, Tadanori AIZAWA*, Kazuzo KATOU*, Ken OGASAWARA*, Hajime KIRIGAYA*, Hiroshi SATOU*, Kiyoshi OKAMOTO*, Hiromitsu HOSOI* |
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| Authors(kana) | |
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| Organization | *The Cardiovascular Institute |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 3 |
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| Page | 249-255 |
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| Year/Month | 1993/3 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Scintigraphic appearance of left anterior descending artery (LAD) lesion in stress 201Tl myocardial SPECT was studied in 43 patients (pts) with midportion lesion in LAD confirmed by coronary angiography. Right margin of ischemic region in the basal short axial image was -36+-17° and left margin was -128+-75°. In 28 pts of 43 pts left margin lied beyond -120°. From the results it was concluded that in most cases basal inferior wall was perfused by septa! branches from LAD. In 6 pts with midportion lesion situated proximal to the first diagonal branch and in 12 pts with midportion lesion situated proximal to the second diagonal branch ischemic region in the apical portion was noted at both septum and anterolateral wall. Critical short axial image, in which right margin of ischemic region shifted from plus to minus area, was the 3.2th short axial image in the former group and the 5.2th in the latter group (p<0.01). In 10 pts with midportion lesion situated distal to the large first diagonal branch, ischemic region was noted in septal wall and not in anterolateral wall. It was concluded that right margin of ischemic region in the basal coronal image was the most useful sign for predicting midportion lesion and left margin for dominancy between LAD and right coronary artery and that apical anterolateral ischemia was sign for LAD lesion involving diagonal branch. Critical short axial image was useful for determining whether the lesion was situated proximal or distal to the first diagonal branch and whether the lesion was situated proximal to the second diagonal branch. |
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| Practice | Clinical medicine |
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| Keywords | 201Tl SPECT, Left anterior descending artery, Midportion lesion, Diagonal branch, Dominancy |
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