| Japanese |
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| Title | 拡張型心筋症における201Tl/123I-MIBG心筋集積局所解離所見の意義 - 心室頻拍発作との関係 - |
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| Subtitle | 原著 |
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| Authors | 前野正和*, 石田良雄*, 下永田剛*, 林田孝平*, 外山卓二*, 広瀬義晃*, 永田正毅**, 宮武邦夫**, 植原敏勇***, 西村恒彦*** |
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| Authors(kana) | |
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| Organization | *国立循環器病センター放射線診療部, **循環器内科, ***大阪大学医学部トレーサ情報解析 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 10 |
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| Page | 1221-1229 |
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| Year/Month | 1993/10 |
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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」 拡張型心筋症 (DCM) 17例を対象として, 201TlCl (Tl) と123I-MIBG (MIBG) の安静時二核種同時収集心筋SPECTを施行し, Tl集積/MIBG欠損の解離を示す領域, すなわち局所交感神経除神経の存在と, 心室頻拍 (VT) 発作の関連を検討した. 欠損の程度は短軸3断面の各6セグメントと長軸心尖部2セグメントの計20セグメントにおいて4段階評価した. 17例中, VT発作を認めた11例 (A群) と認めなかった6例 (B群) の二群間に, TlとMIBGの欠損スコア (DS) の総和 (TDS) に有意差はなかったが, 各症例でのTlとMIBG像のTDSの差 (A群:B群=13.5±6.5:5.8±3.0, P<0.05) およびDSが解離したセグメント数 (A群:B群=12.5±3.0:8.3±1.5, P<0.01) はA群が有意に大であった. 電気生理検査を施行した5例中3例において, VTのfractionated areaとTl/MIBG解離部位が一致した. 以上より, 局所交感神経除神経のDCMにおけるVT発作の出現への関与が示唆され, したがってTl/MIBG解離部位の検出がVT発作の予測に有効である可能性が示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | 123I-metaiodobenzylguanidine (MIBG) , Sympathetic denervation, Ventricular tachycardia, Idiopathic dilated cardiomyopathy. |
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| English |
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| Title | The Significance of 201Tl/123I MIBG (Metaiodobenzylguanidine) Mismatched Myocardial Regions for Predicting Ventricular Tachycardia in Patients with Idiopathic Dilated Cardiomyopathy |
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| Subtitle | Original Articles |
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| Authors | Masakazu MAENO*, Yoshio ISHIDA*, Tsuyoshi SHIMONAGATA*, Kohei HAYASHIDA*, Takuji TOYAMA*, Yoshiaki HIROSE*, Masaki NAGATA*, Kunio MIYATAKE*, Toshiisa UEHARA**, Tsunehiko NISHIMURA** |
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| Authors(kana) | |
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| Organization | *National Cardiovascular Center, **Osaka University |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 10 |
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| Page | 1221-1229 |
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| Year/Month | 1993/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] 123I-MIBG (MIBG) regional defects in myocardial regions with preserved 201Tl (Tl) uptake have been observed in patients with idiopathic dilated cardiomyopathy (DCM) . To evaluate whether the presense of Tl/MIBG mismatched regions is related to the occurrence of ventricular tachycardia (VT) , we performed myocardial dual SPECT imaging with Tl (111 MBq) and MIBG (111 MBq) in 17 patients with DCM, 11 (Gp A) with and 6 (Gp B) without VT. Myocardial dual SPECT imaging was performed at 15 minutes after and 4 hours after the tracer injection. The regional tracer uptake was scored visually in 6 segments of the basal, middle, and apical short-axial images and in 2 apical segments of the midventricular vertical long-axial image by a four-point scoring system (0=normal, 1=moderate, 2=severe and 3=complete defect) . Then, the severity of tracer maldistributions was assessed by the difference between total defect scores (TDSs) of Tl and MIBG (ΔTDS) . TDS was not different between Gps A and B in both Tl and MIBG images. However, ΔTDS was larger in Gp A than in Gp B (13.5+-6.5 vs. 5.8+-3.0, p<0.05) . Also, the number of segments with the mismatched tracer uptake was larger in Gp A than in Gp B (12.5+-3.0 vs. 8.3+-1.5, p<0.01) . In the electrophysiologic study, we found that the fractionated area corresponded to the mismatched region in 3 of 5 patients in Gp A. These results suggest that regional sympathetic denervation is a possible factor which provocates VT, and myocardial dual SPECT imaging with Tl and MIBG is a useful method for predicting VT in patients with DCM. |
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| Practice | Clinical medicine |
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| Keywords | 123I-metaiodobenzylguanidine (MIBG) , Sympathetic denervation, Ventricular tachycardia, Idiopathic dilated cardiomyopathy. |
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