| Japanese |
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| Title | 運動負荷201Tl-SPECT再静注法を用いた心筋viabilityの定量的評価法 - 心筋梗塞例における安静時法との比較 - |
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| Subtitle | 原著 |
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| Authors | 小林史*, 中田智明*, 土橋和文*, 田中繁道*, 飯村攻* |
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| Organization | *札幌医科大学医学部内科学第二講座 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 1 |
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| Page | 63-74 |
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| Year/Month | 1995/1 |
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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」心筋梗塞症43例を対象に, 定量的運動負荷201Tl心筋SPECT再静注法 (二次元極座標表示法) による, 心筋viability定量法の有用性, 妥当性を安静時法と対比検討した. 冠灌流異常の程度の指標であるseverity scoreでは非可逆的灌流異常の検出上, 再静注像 (87±12) と安静時像 (81±10) の間に有意差はなく, 両者は有意に正相関 (r=0.85, p<0.001) した. 可逆的灌流異常の検出においても, 再静注像 (44±5) と安静時像 (33±8) の間に有意差は認められず, 両者は有意に正相関 (r=0.55, p<0.05) した. さらに, 冠血管再建術を施行した18例を対象に, 術前に心筋viabilityを評価する上での再静注法の有用性を検討した. 再静注像と安静時像からえられた術前の可逆的灌流異常は, 術前後における虚血改善度と有意に正相関 (再静注, r=0.80, p<0.001 ; 安静時, r=0.71, p<0.05) した. 以上より, 定量的運動負荷201Tl心筋SPECT再静注法は, 心筋viabilityの評価上, 安静時法と同等の精度を有し, 加えて冠血管再建術前後での心筋虚血改善度の予測にもきわめて有用と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Exercise-stress thallium-201 reinjection with SPECT, Coronary artery disease, Myocardial viability, Extent score, Severity score |
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| English |
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| Title | Quantitative Assessment of Myocardial Viability by Thallium-201 Reinjection with SPECT : Comparative Studies with Resting Image in Myocardial Infarction |
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| Authors | Hiroshi KOBAYASHI, Tomoaki NAKATA, Kazufumi TSUCHIHASHI, Shigemichi TANAKA, Osamu IIMURA |
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| Organization | Second Department of Internal Medicine, Sapporo Medical University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 1 |
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| Page | 63-74 |
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| Year/Month | 1995/1 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Exercise-stress thallium (Tl) scintigraphy is a reliable diagnostic tool for evaluating the reversibility of injury to the myocardium ; however, over-estimation of infarcted volume has been considered as a clinical limitation, both in recent and in old myocardial infarctions. To reveal the clinical efficacy of reinjection modification, infarcted and ischemic myocardium were quantitatively evaluated by stress, reinjection, and resting image with 201Tl SPECT in 43 patients with myocardial infarction. A quite significant correlation was found in severity scores from reinjection and resting images (87+-12 vs. 81+-10, r=0.85, p<0.001), these were significantly lower than the scores from post-exercise (124+-13) and 4-hour delayed (103+-11) images. The fractions of reversible ischemic myocardium predicted by reinjection and resting images also correlated with each other (r=0.55, p<0.05) and were significantly larger than those from 4-hour delayed images. Furthermore, the degree of redistribution of myocardial perfusion observed in reinjection image showed a significant positive linear correlation with improved myocardial perfusion after coronary revascularization (r=0.80, p<0.001), while that from the 4-hour delayed image did not. These results suggest that the severity score of thallium reinjection method is useful for quantifying both labile and non-labile myocardium after myocardial infarction and contributes to predicting the effect of coronary revascularization therapy. |
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| Practice | Clinical medicine |
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| Keywords | Exercise-stress thallium-201 reinjection with SPECT, Coronary artery disease, Myocardial viability, Extent score, Severity score |
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