Japanese
Title99mTc-methoxy isobutyl isonitrile (MIBI) を用いての心拍同期SPECTによる左室壁運動異常の検出
Subtitle技術報告
Authors今井嘉門*, 荒木康史**, 斎藤頴**, 小沢友紀雄**, 八杉忠男**, 鎌田力三郎***
Authors(kana)
Organization*埼玉県循環器病センター準備室, **日本大学医学部第二内科, ***日本大学医学部放射線科
Journal核医学
Volume30
Number3
Page323-330
Year/Month1993/3
Article報告
Publisher日本核医学会
Abstract「要旨」 99mTc-methoxy isobutyl isonitrile(MIBI)で, 左室の壁運動異常を検出できるか, 心筋梗塞症6症例で, 心拍同期SPECTを記録し検討した. 心臓の短軸像の収縮期カウント(ESC)および拡張期カウント(EDC)を求め, %(ESC-EDC)および(ESC-EDC)/EDCをおのおの計測した. 左室の壁運動は8区画に分割して検討した. 6症例の48区画のうち, 33区画は正常壁運動(NM)を, 15区画は異常壁運動(AM)を示した. %(ESC-EDC)はNMでは74.39±16.85%, AMでは33.27±23.56%であった(p<0.001). (ESC-EDC)/EDCはNMでは48.67±13.35%, AMでは23.33±18.83%であった(p<0.001). %(ESC-EDC)および(ESC-EDC)/EDCの正常下限値(mean-2SD)を40, 22と定め, AM診断の正診率を求めた. 陽性検出率は%(ESC-EDC):73%, (ESC-EDC)/EDC:60%で, 陰性検出率は%(ESC-EDC):94%, (ESC-EDC)/EDC:97%で, 両指標の間に有意差を認めなかった. 冠灌流を検出するMIBI心筋シンチで, 壁運動異常をも診断できる可能性を示唆する結果が得られた.
Practice臨床医学：一般
KeywordsMyocardial infarction, Wall motion abnormality, Gated single photon emission computed tomography, 99mTc-methoxy isobutyl isonitrile (MIBI)
English
TitleUsefulness of Electrocardiogram Gated 99mTc-Methoxy Isobutyl Isonitrile (MIBI) Single Photon Emission Computed Tomography for Detection of Wall Motion Abnormality of Left Ventricle
Subtitle
AuthorsKamon IMAI*, Yasushi ARAKI**, Satoshi SAITO**, Yukio OZAWA**, Tadao YASUGI**, Rikisaburou KAMATA***
Authors(kana)
Organization*Project Office for the Saitama Cardiovascular Center, **Second Department of Internal Medicine, ***Department of Radiology, Nihon University, School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume30
Number3
Page323-330
Year/Month1993/3
ArticleReport
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractWe evaluated whether the newly developed perfusion imaging agent "99mTc-methoxy isobutyl isonitrile (MIBI)" has a possibility to detect wall motion abnormality of left ventricle. Electrocardiogram (ECG) gated single photon emission computed tomography (SPECT) was performed in 6 patients with myocardial infarction (anterior: 3 and inferior: 3). Apical and basal short axis images were selected from each patient and circumferential analysis was performed on end-diastolic (ED) and end-systolic (ES) images respectively. Count in end-diastole (EDC) and count in end-systole (ESC) were obtained, then % (ESC-EDC) and (ESC-EDC)/EDC were calculated. Wall motion of left ventricle was evaluated by either ultrasonic cardiogram or left ventriculography. Left ventricle was divided into anterior, septal, posterior and lateral areas and then each area was divided into apical and basal segments (finally the heart was divided into 8 segments). Of 48 segments, 33 segments showed normal wall motion and 15 segments showed abnormal wall motion: hypokinesis, akinesis and dyskinesis. % (ESC-EDC) was 74.39+-16.85% in segment of normal wall motion and 33.27+-23.56% in segment of abnormal wall motion (p<0.001). (ESC-EDC)/EDC was 48.67+-13.35% in segment of normal wall motion and 23.33+-18.83% in segment of abnormal wall motion (p<0.001). From these data, lower limit of % (ESC-EDC) and (ESC-EDC)/EDC in normal wall motion was defined as 40 and 22 respectively: mean-2SD of normal wall motion. Sensitivity of diagnosis of abnormal wall motion was 73% in % (ESC-EDC) and 60% in (ESC-EDC)/EDC (n.s.). Specificity was 94% and 97% (n.s.). From our results, wall motion of left ventricle can be evaluated by using ECG gated SPECT with MIBI as well as detecting perfusion of myocardium. Therefore, this method would seem to be useful.
PracticeClinical medicine
KeywordsMyocardial infarction, Wall motion abnormality, Gated single photon emission computed tomography, 99mTc-methoxy isobutyl isonitrile (MIBI)

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