Japanese
Title心筋ゲートSPECTによる心筋収縮・弛緩機能の評価
Subtitle原著
Authors足立至*, 杉岡靖*, 田渕耕次郎*, 山本和宏*, 辰吉光*, 雑賀良典*, 西垣洋*, 松井律夫*, 末吉公三*, 楢林勇*, 田本重美**, 大竹義章***
Authors(kana)
Organization*大阪医科大学放射線科, **第一内科, ***第三内科
Journal核医学
Volume31
Number12
Page1453-1463
Year/Month1994/12
Article原著
Publisher日本核医学会
Abstract「要旨」心筋ゲートSPECTを施行し自動輪郭抽出法による心筋容量曲線の作成を24症例に試みたところ以下の結果を得た. 集積異常のない心筋や肥大した心筋では閾値50-60%の自動輪郭抽出法を用いることで同一平面上で心筋の移動に追従することができ, また心筋梗塞などの集積低下した部位では閾値20%程度で輪郭抽出できた. 健常者の心筋容量曲線は拡張期に急速に心筋の弛緩があり, 続いて緩徐に弛緩するパターンが得られた (N型). 心筋容量曲線の収縮遅延パターン (DC型) は心筋集積低下を認めた部位で多く見られ, 弛緩遅延パターン (DR型) は心筋集積増加部位で多く見られ, 心筋の梗塞部位や肥厚部位の性状と心筋容量変化の関連が示唆された. 下壁が腹部臓器との重なりのために心筋容量曲線の作成が困難な症例も見られた. 心筋容量曲線の視覚的な分類においても心筋の収縮期の収縮機能のみならず拡張期の心筋の弛緩能も評価可能と考えられた.
Practice臨床医学：一般
KeywordsDiastolic function, 99mTc-tetrofosmin, Multi-gated SPECT, Myocardial scintigraphy
English
TitleAssessment of Myocardial Contraction and Relaxation with 99mTc-Tetrofosmin Multi-Gated Myocardial SPECT
SubtitleOriginal Articles
AuthorsItaru ADACHI*, Yasushi SUGIOKA*, Koujirou TABUCHI*, Kazuhiro YAMAMOTO*, Yoshimitsu TATSU*, Yoshinori SAIKA*, Hiroshi NISHIGAKI*, Ritsuo MATSUI*, Kouzou SUEYOSHI*, Isamu NARABAYASHI*, Shigemi TAMOTO**, Yoshiaki OHTAKE***
Authors(kana)
Organization*Department of Radiology, **First Department and ***Third Department of Internal Medicine, Osaka Medical College
JournalThe Japanese Journal of nuclear medicine
Volume31
Number12
Page1453-1463
Year/Month1994/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Myocardial relaxation at the diastolic phase was not evaluated by multi-gated myocardial SPECT, although myocardial contraction at the systolic phase was studied by percent wall thickening and Bull's eye methods. We make out a myocardial volume curve and report to evaluate the myocardial relaxation using multi-gated myocardial SPECT. The study population consisted of 3 normal human subjects (3 male, 32-37 years old), 10 idiopathic cardiomyopathy, 10 coronary artery disease and 1 hypertensive heart disease combined with aortic regurgitaion. All cases were injected 555 MBq of 99mTc-tetrofosmin (Amersham Healthcare Corporation) intravenously at rest. A triple detector gamma-camera (GCA-9300A, Toshiba Medical, Japan) and a data processing computer (GMS-5500A, Toshiba Medical, Japan) were used in this study. A cardiac cycle (R-R interval) was divided by 16 frames (50-80 msec per 1 frame). Eight myocardial volume curves were calculated at the anterior wall, apex and inferior wall of the vertical long axis view and were calculated at the septal wall, apex and lateral wall of the horizontal long axis view, respectively. The patterns of the myocardial volume curves were classified into 5 patterns (Normal pattern (N), Delayed Contraction pattern (DC), Delayed Relaxation pattern (DR), Mixed pattern (M) and Normal pattern with Decreased amplitude (ND)). Myocardial uptake was evaluated visually of grading into severe hypertrophy (5), hypertrophy (4), normal (3), mild hypoperfusion (2), hypoperfusion (1) and perfusion defect (0). We compared patterns of the myocardial volume curves to myocardial uptake in the same segments. It was possible to detect myocardial edge of the total 16 frames with 50-60% threshold in the normal volunteer and in patients with hypertrophic cardiomyopathy and to make a myocardial volume curve. The region of the severe myocardial perfusion defect could be detected with 20% threshold in patients with old myocardial infarction. In comparison with myocardial volume curves and myocardial uptake, 74.6% in the N pattern had a normal uptake (3), 66.7% in the ND pattern had a normal uptake (3), 61.5% in the DC pattern had a hypoperfusion segment (0, 1 or fill-in to normal uptake), 44.4% in the DR pattern had a hypertrophic segment (4, 5 or fill-in to increased uptake). The pattern of myocardial volume curve indicates myocardial contractility and relaxation in each myocardial segment.
PracticeClinical medicine
KeywordsDiastolic function, 99mTc-tetrofosmin, Multi-gated SPECT, Myocardial scintigraphy

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