| Japanese |
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| Title | 拡張型心筋症における201Tl心筋シンチグラフィ像と心内膜心筋生検での心筋線維化像の対比検討 |
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| Subtitle | 原著 |
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| Authors | 李林雪*, 野原隆司*, 小野晋司***, 奥田和美*, 田中昌*, 藤原久義*, 的場芳樹*, 松森昭*, 藤田正俊****, 玉木長良**, 小西淳二**, 篠山重威* |
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| Authors(kana) | |
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| Organization | *京都大学医学部第三内科, **核医学科, ***滋賀成人病センター, ****京都医療短期大学 |
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| Journal | 核医学 |
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| Volume | 31 |
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| Number | 3 |
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| Page | 231-240 |
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| Year/Month | 1994/3 |
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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」 拡張型心筋症 (DCM) 22例について, 201Tl心筋SPECT像と心内膜心筋生検所見を用い対比検討した. 201Tl心筋SPECTでは視覚的判断より, 心筋梗塞とは異なる多発性灌流欠損 (patchy pattern) を重症度別に四段階に分類した. また, 死亡したDCM患者4例の剖検結果と201Tl心筋SPECTの灌流欠損像との関連性も比較した. 拡張型心筋症患者22例のうち, 21名 (95%) が心筋線維化を示した. 18名 (82%) に, 201Tl心筋SPECTで灌流欠損陽性所見を認めた. このうち17名にpatchy patternを認めた. これより, 心筋生検で組織線維化が認められた症例中81% (17/21) に201Tl心筋SPECT上でpatchy patternの出現を認めたことになる. また死亡患者4例の201Tl所見と心臓剖検心筋組織線維化の重症度とを比較して, これらの所見がよく一致していることを確認した. DCMにおける201Tl心筋SPECTの欠損像, とくにpatchy patternの有無は, 心筋組織線維化の検出程度とよく一致することが示唆された. しかし, 臨床上は両者のgradingの関係が, r=0.385と相関は低かった. また, 201Tl心筋SPECTのstage分類は, 心駆出率, および左室径とは相関しなかった. したがって, DCMにおける, 201Tl心筋SPECT画像にみるpatchy patternの有無は正確な臨床上のgradingには問題を残すが, 心機能とは独立した心筋組織線維化の異常検出の程度とよく一致していることが示された. |
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| Practice | 臨床医学：一般 |
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| Keywords | 201Tl-SPECT, Dilated cardiomyopathy (DCM) , Endomyocardial fibrosis. |
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| English |
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| Title | Comparative Study of 201Tl-Scintigraphic Image and Endomyocardial Biopsy Findings in Patients with Dilated Cardiomyopathy |
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| Subtitle | Original Articles |
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| Authors | Linxue LI*, Ryuji NOHARA*, Shinji ONO***, Kazumi OKUDA*, Masaru TANAKA*, Hisayoshi FUJIWARA*, Yoshiki MATOBA*, Akira MATSUMORI*, Masatoshi FUJITA*, Shigetake SASAYAMA*, Nagara TAMAKI**, Junji KONISHI** |
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| Authors(kana) | |
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| Organization | *Third Division, Department of Internal Medicine, **Department of Nuclear Medicine, Kyoto University Faculty of Medicine, ***Adult Disease Center |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 31 |
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| Number | 3 |
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| Page | 231-240 |
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| Year/Month | 1994/3 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] 201Tl-SPECT image was compared with the findings of endomyocardial biopsy in patients with dilated cardiomyopathies (DCM) , and diagnostic value of 201Tl patchy pattern image for fibrosis with DCM was evaluated. Serial 22 patients diagnosed as DCM with endomyocardial biopsy findings were selected for this study (age:50+-17 y.o., Male/Female=17/5) . Patchy pattern of 201Tl-SPECT image was visually classified to 4 stage according to the severity of inhomogeneous defect, and pathologic findings of fibrosis was also classified into 4 according to the severity of fibrosis (0:none, 1:mild, 2:moderate, 3:severe) . Ejection fraction calculated from left ventriculography and end-diastolic dimension by echocardiography were also compared with 201Tl-SPECT image. Out of 22 patients, 21 patients (95%) showed fibrosis, and 18 patients (82%) showed patchy pattern with 201Tl-SPECT. Severity of patchy pattern was not in good relation to that of fibrosis (r=0.374) . 201Tl image was not related to the function nor dimension. Four autopsy studies revealed a good relation of macroscopic severity, spatial distribution of fibrosis and inhomogeneous 201Tl-defect pattern before death. Patchy pattern of 201Tl-SPECT image will show the myocardial fibrosis in patients with DCM, and is independent of the function. 201Tl-SPECT may show more clinically useful findings of spatial distribution and severity of fibrosis with focal myocardial biopsy. |
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| Practice | Clinical medicine |
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| Keywords | 201Tl-SPECT, Dilated cardiomyopathy (DCM) , Endomyocardial fibrosis. |
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