| Japanese |
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| Title | タリウム心筋シンチグラフイによる心筋viability診断 |
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| Subtitle | 原著 |
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| Authors | 今井嘉門*, 荒木康史**, 堀内孝一**, 弓倉整**, 斎藤頴**, 小沢友紀雄**, 上松瀬勝男**, 萩原和男*** |
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| Organization | *埼玉県循環器病センター準備事務所, **日本大学医学部第二内科, ***日本大学板橋病院RI室 |
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| Journal | 核医学 |
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| Volume | 31 |
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| Number | 5 |
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| Page | 489-495 |
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| Year/Month | 1994/5 |
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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」心筋梗塞部位のviability(V)を冠血行再建術(RV)前に診断することは臨床上重要で, タリウム(Tl)心筋シンチが汎用されている. しかし, 心筋シンチの再分布の有無による診断はVを過小に評価する. 今回簡便な診断方法として%Tl-uptake法を提唱し, 梗塞部位にPTCAを, その前後に心筋シンチを施行した23症例(左室を12区画に分割)で検討した. PTCAが施行された113区画のうち, V(+)は43区画, V(-)は70区画であった. Vを, 1)再分布(RD), 2)運動負荷直後画像の%Tl-uptake≧45%(TE), 3)遅延像の%Tl-uptake≧45%(TD)で診断した. Sensitivity(SE)はRD:60%, TE:90%, TD:95%で(p<0.001 vs. RD), specificity(SP)はRD:74%, TE:68%, TD:60%であった(NS). Predictive accuracy(PA)はRD:69%, TE:77%, TD:73%であった(NS). %Tl-uptake(TE法およびTD法)は, RD法と比較してSPを多少低下させるも, PAを多少改善し, SEを向上させた. %Tl-uptakeはRVの適応患者を選択する際に簡便で, 有用な検査方法である. |
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| Practice | 臨床医学：一般 |
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| Keywords | Myocardial viability, Infarcted myocardium, Thallium myocardial scintigraphy. |
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| English |
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| Title | Detection of Viability by Percent Thallium Uptake with Conventional Thallium Scintigraphy |
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| Subtitle | Original Articles |
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| Authors | Kamon IMAI*, Yasushi ARAKI**, Kou-ichi HORIUCHI**, Sei YUMIKURA**, Satoshi SAITO**, Yukio OZAWA**, Katsuo KAN-MATSUSE**, Kazuo HAGIWARA*** |
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| Organization | *Project Office for the Saitama Cardiovascular Center, **Second Department of Internal Medicine, Nihon University School of Medicine, ***Division of Nuclear Medicine, Itabashi Nihon University Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 31 |
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| Number | 5 |
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| Page | 489-495 |
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| Year/Month | 1994/5 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Thallium myocardial scintigraphy (TMS) is used for diagnosis of viability in infarcted myocardium before coronary revascularization. Underestimation of viability by TMS has been reported by many investigators. To evaluate viability precisely, thallium re-injection method or 24 hour delayed imaging is performed. However these techniques are not convenient and are difficult to perform in clinical practice. Percent Tl-uptake method was developed for predicting myocardial viability. To evaluate usefulness of this method, TMS was performed before and after PTCA in 23 patients with myocardial infarction. Left ventricle was divided into 3 layers, then each layer was divided into 4 segments (12 segments in total). Forth three segments showed recovery of perfusion on TMS after PTCA. Viability in infarcted myocardium is predicted by 1) redistribution (RD), 2) %Tl-uptake>=45% on the image immediately after exercise (TE), and 3) %Tl-uptake>=45% on delayed image (TD). Sensitivity was RD: 60%, TE: 90% and TD: 95% (p<0.001 vs. RD). Specificity was RD: 74%, TE: 68%, and TD: 60% (NS), Predictive accuracy (PA) was RD: 69%, TE: 77%, TD: 73% (NS). Compared with RD, %Tl-uptake, either TE or TD, increased sensitivity with slightly improved PA, but decreased specificity slightly. Therefore %Tl-uptake would be a sensitive and useful predictor to find patients who are most likely to benefit from re-vascularization. |
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| Practice | Clinical medicine |
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| Keywords | Myocardial viability, Infarcted myocardium, Thallium myocardial scintigraphy. |
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