Japanese
Title本態性高血圧における123I-metaiodobenzylguanidine (123I-MIBG) 心筋イメージング - 123I-MIBGイメージングは高血圧の予後判定に有用か? -
Subtitle原著
Authors成田充啓*, 栗原正*, 村野謙一*, 宇佐美暢久*, 本田稔**
Authors(kana)
Organization*住友病院内科, **アイソトープ検査部
Journal核医学
Volume31
Number8
Page879-889
Year/Month1994/8
Article原著
Publisher日本核医学会
Abstract「要旨」本態性高血圧(HT)における心筋norepinephrine(NE)活性を, 123I-metaiodobenzylguanidine(MIBG)心筋イメージングを用い定量的に評価し, その有用性を左心予備能との関連より検討した. 対象はHT16例と健常例9例で, 安静時に123I MIBGおよび201Tlイメージング(断層像と全身像)を行った. 123I-MIBGの心筋への取り込みの定量法として, 全身像をもとに, 123I-MIBGの心臓への集積を201Tlの心臓集積で補正したUptake Ratio(UR)を用いた. 心筋内123I-MIBG分布の均一性を, Bull's-eye mapにおける123I-MIBGの変動係数(CV)より検討した. 運動負荷(Ex)99mTc心プールシンチをもとに, HTをExにより左室駆出率(EF)が増加した群(8例)とEF低下群(6例)に分けて検討すると, EF低下群ではEF増加群や健常群に比しURは有意に低く, CVは大であった. 心不全既往の2例でも同一の傾向を示した. 123I-MIBGの取り込みや心筋内分布の異常はHTの予後を推測する上で有用な指標になりうると考えられた.
Practice臨床医学：一般
Keywords123I-MIBG myocardial imaging, Essential hypertension, Uptake ratio, Unhomogeneity of 123I-MIBG distribution.
English
TitleMyocardial Imaging with 123I-Metaiodobenzylguanidine (123I-MIBG) in Essential Hypertension : Does the 123I-MIBG Imaging Have the Ability to Predict Its Prognosis?
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Kenichi MURANO*, Masahisa USAMI*, Minoru HONDA**
Authors(kana)
Organization*Department of Internal Medicine, Sumitomo Hospital, **Department of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume31
Number8
Page879-889
Year/Month1994/8
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] To study myocardial norepinephrine (NE) activity in essential Hypertension (HT) and to clarify its prognostic significance, we performed myocardial imaging with 123I-metaiodobenzylguanidine (123I-MIBG) and 201Tl at rest in 16 patients with HT and 9 normal subjects. In addition to ordinary tomograms, whole body images were obtained in both 123I-MIBG and 201Tl imaging. From the whole body image, a ratio of myocardial radionuclide accumulation to total injected dose was calculated (% Uptake). And Uptake Ratio (% Uptake of 123I-MIBG / % Uptake of 201T was used as an index of myocardial 123I-MIBG uptake. Reduction of myocardial 123I-MIBG during 3 hours was calculated and expressed as washout rate (WOR). From the Bull's-eye map, the extent of defect was quantitatively assessed (Defect Score) and the homogeneity of the radionuclide distribution within the myocardium (CV) was calculated. In 123I-MIBG imaging, defect appeared in 12 patients with HT (75%), but in normal subject no one showed defect. Patients with HT were divided into two groups according to left ventricular ejection fraction (EF) responses to exercise stress which were obtained by 99mTc blood pool imaging. Group 1 consisted of 8 patients who showed EF elevation (5-10%) by exercise and group 2 consisted of 6 patients with depression of EF (-4-6%) by exercise. Rest EF, peak filling rate, exercise heart rate, exercise blood pressure and left ventricular mass were identical between two groups. Uptake Ratio in Group 2 (0.67+-0.04) was significantly smaller (p<0.05) than those in Group 1 (0.75+-0.05) and normal subject (0.75+-0.06). And in Group 2, WOR of 123I-MIBG was greater than that of Group 1. In Group 2, defect of 123I-MIBG appeared in all patients, but in Group 1 defect developed in 50%, besides Defect Score was significantly greater in Group 2 than in Group 1 (3.8+-14 vs. 1.5+-1.8, p<0.05). The unhomogeneity of 123I-MIBG distribution was significantly greater in Group 2 (CV; 30±5%) than in Group 1 (21+-4%) and in normal subjects (18+-4%). These results suggested that quantitative analysis of 123I-MIBG imaging may be helpful for assessing the prognosis of HT.
PracticeClinical medicine
Keywords123I-MIBG myocardial imaging, Essential hypertension, Uptake ratio, Unhomogeneity of 123I-MIBG distribution.

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