Japanese
Title冠血管再建術前後における冠血流異常の定量的評価と心筋viabilityの過小評価 - 運動負荷 201Tl SPECT bull's eye法, 展開図法を用いて -
Subtitle原著
Authors長尾和彦*, 中田智明*, 土橋和文*, 小林史*, 長谷守*, 曳田信一*, 田中繁道*, 久保田昌宏**, 津田隆俊**, 飯村攻*
Authors(kana)
Organization*札幌医科大学医学部第二内科, **放射線科
Journal核医学
Volume31
Number4
Page337-345
Year/Month1994/4
Article原著
Publisher日本核医学会
Abstract「要旨」梗塞後狭心症 (PMI) 34例と労作性狭心症 (AP) 13例を対象に, 冠血管再建術前後で運動負荷201Tl SPECTを施行し, bull's eye法, 展開図法にて心筋虚血量を定量的に解析した. 術前の心筋虚血検出率, 虚血量は両群間で差を認めず. しかし, PMI群では術前虚血量が術後改善度に比し有意に低値で, 術後改善した虚血量のextent score 32%, severity score 69%, ischemic area 48%にとどまった. また, 術前虚血スコアにより術後改善度を予測すると, AP群では予測良好群が70-89%である一方, PMI群では35-57%にとどまり, 予測不良群が29-42%存在した. 以上, 定量的運動負荷201Tl SPECT法は虚血の検出と定量化から冠血管再建術の評価上有用と考えられた. しかし, PMIの約33%の症例で可逆的心筋虚血量 (心筋viability) を約50%過小評価することも明らかとなり, 3-4時間後再分布像の限界が明らかとなった.
Practice臨床医学：一般
Keywords201Tl SPECT, Bull's eye method, Quantitative analysis, Myocardial viability, Revascularization.
English
TitleQuantification of Reversible Perfusion Abnormality Using Exercise-Stress Thallium SPECT before and after Coronary Revascularization
SubtitleOriginal Articles
AuthorsKazuhiko NAGAO*, Tomoaki NAKATA*, Kazufumi TSUCHIHASHI*, Hiroshi KOBAYASHI*, Mamoru HASE*, Nobuichi HIKITA*, Shigemichi TANAKA*, Masahiro KUBOTA**, Takatoshi TSUDA**, Osamu IIMURA*
Authors(kana)
Organization*Second Department of Internal Medicine, **Department of Radiology, School of Medicine, Sapporo Medical University
JournalThe Japanese Journal of nuclear medicine
Volume31
Number4
Page337-345
Year/Month1994/4
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Reversible myocardial perfusion abnormality was quantified by bull's eye and unfolded surface mapping methods in exercise thallium SPECT before and after coronary revascularization in 47 patients with angina pectoris, including 34 patients with previous myocardial infarction (PMI) and 13 with effort angina (AP) . There was no difference in the incidence or extent of myocardial ischemia between the 2 groups before revascularization. However, the ischemic scores were significantly smaller in PMI group preoperatively than the reductions of the ischemic scores after revascularization. The ischemic scores, preoperatively estimated reversible perfusion abnormality was 32%, 69% and 48% of the improvement of the ischemic score (extent score, severity score, and ischemic area, respectively) . Using the 3 ischemic scores, the improvement of perfusion abnormality was well predicted in 70-89% of AP patients but 35-57% of PMI patients. Thus, quantitative analysis in stress thallium SPECT is useful for detecting myocardial ischemia and evaluating the effect of coronary revascularization. However, about a half of myocardial viability was underestimated in one third of PMI patients by the conventional exercise-stress thallium SPECT study.
PracticeClinical medicine
Keywords201Tl SPECT, Bull's eye method, Quantitative analysis, Myocardial viability, Revascularization.

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