| Japanese |
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| Title | 急性心筋梗塞における99mTc-PYPと201Tlを用いたdual-SPECTによる心筋viabilityの定量的評価ならびに再灌流療法の検討 |
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| Subtitle | 原著 |
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| Authors | 小林裕*, 宮城学*, 中島均*, 渡辺健*, 永井義一*, 伊吹山千晴* |
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| Organization | *東京医科大学内科学第二講座 |
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| Journal | 核医学 |
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| Volume | 31 |
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| Number | 10 |
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| Page | 1227-1236 |
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| Year/Month | 1994/10 |
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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」急性心筋梗塞70例に対し99mTc-PYPと201Tlを用いたdual-SPECTを施行し梗塞巣における201Tlと99mTc-PYPのoverlap領域の割合(Y-ratio)を定量的に評価し, その有用性を検討した. 慢性期の運動負荷心筋シンチとY-ratioの検討では梗塞巣に再分布を認める症例で同値は高値を示し, 左室壁運動との比較では心筋梗塞にも関わらず梗塞部がnormokinesisを示す症例で高値を示した. Y-ratioは心筋viabilityの定量的評価に有用であり, 同値が60%以上の症例ではviabilityの存在が示唆された. 急性期再灌流療法(ICTまたはdirect-PTCA)を施行した30例においてY-ratioを比較検討したところ, ICT群とdirect-PTCA群間で同値に有意差は認められなかった. しかし, 再灌流が6時間以内になされた症例では, それ以降の症例に比較しY-ratioは有意に高値を示し, 9時間以内では再灌流までの時間と(100-Y-ratio)間に有意な正相関(r=0.63, p<0.01)が認められた. Y-ratioは心筋viabilityの評価に有用であり心筋salvageの観点からは, ICTとdirect-PTCAの間に差はなく, 一刻も早く再灌流を得ることが肝要と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Acute myocardial infarction, Dual-SPECT, Myocardial viability, Intracoronary thrombolysis, Direct-PTCA. |
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| English |
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| Title | Evaluation of Myocardial Viability and Efficacy of Reperfusion Therapy by Dual-SPECT Using 99mTc-PYP and 201Tl in Acute Myocardial Infarction |
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| Authors | Hiroshi KOBAYASHI, Manabu MIYAGI, Hitoshi NAKAJIMA, Takeshi WATANABE, Yoshikazu NAGAI, Chiharu IBUKIYAMA |
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| Authors(kana) | |
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| Organization | Second Department of Internal Medicine, Tokyo Medical College |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 31 |
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| Number | 10 |
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| Page | 1227-1236 |
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| Year/Month | 1994/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Dual SPECT using 99mTc-PYP and 201Tl was performed in 70 patients with acute myocardial infarction, and the ratio of overlap zone between 201Tl and 99mTc-PYP uptake in the infarcted area was determined (the Y-ratio). The Y-ratio was significantly higher in the group with redistribution in the infarcted area on exercise thallium myocardial scintigraphy in the chronic stage of infarction, as well as in the group with normal left ventricular wall motion. Thus, the Y-ratio value was apparently useful in the evaluation of myocardial viability. Patients from 60% of the Y-ratio upward are suggested that myocardial viability had been survived. When the Y-ratio was determined in 30 patients who underwent early reperfusion therapy (ICT or direct-PTCA), no significant difference was found between the ICT group and the direct-PTCA group. However, the Y-ratio was significantly higher when reperfusion was performed within 6 hours than when it was performed after 6 hours, and a significant positve correlation (r=0.63, p<0.01), was found between reperfusion time from cardiac event within g hours and the value of (100-the Y-ratio). Conclusion: The Y-ratio was grateful appeared to be useful for the quantitative evaluation of myocardial viability in the acute stage of myocardial infarction. In addition, it appears to be important to perform reperfusion as soon as possible to improve myocardial salvage. |
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| Practice | Clinical medicine |
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| Keywords | Acute myocardial infarction, Dual-SPECT, Myocardial viability, Intracoronary thrombolysis, Direct-PTCA. |
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