| Japanese |
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| Title | 陳旧性心筋梗塞例におけるTl再静注でFill-inを示す心筋での脂肪酸代謝に関する検討 |
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| Subtitle | 原著 |
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| Authors | 松成一朗*, 藤野晋**, 滝淳一***, 中嶋憲一***, 西川高広*, 一柳健次*, 利波紀久***, 久田欣一*** |
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| Authors(kana) | |
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| Organization | *福井県立病院放射線科, **内科, ***金沢大学医学部核医学科 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 2 |
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| Page | 147-153 |
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| Year/Month | 1995/2 |
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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」Tl再静注で新たにFill-inを示す虚血心筋での脂肪酸利用を評価する目的で, 通常の運動負荷, 再分布Tlシンチグラフィで非可逆性欠損を呈する陳旧性心筋梗塞患者22例に再静注Tlシンチグラフィを施行し, 安静BMIPP像と比較検討した. 運動負荷, 再分布Tlシンチグラフィで非可逆性欠損と判定されたのは全462領域中, 199領域であった. このうち, Tl再静注像でFill-inありと判定された73領域中65領域 (89%) でBMIPP集積の低下を認めた. 定量的評価でも, Fill-inを示す虚血心筋では再静注像でのTl集積に比し, BMIPP集積低下が著明であった (65.8±16.0 vs. 49.7±16.1%, p<0.001). 一方, Tl再静注像でFill-inを呈さない126領域中, BMIPP集積の低下を認めたのは24領域 (19%) のみであった. 以上, BMIPP像を運動負荷, 再分布, 再静注Tl像と組み合わせることにより, Tl再静注で新たにFill-inを認める虚血心筋での脂肪酸利用障害の存在が示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid, SPECT, Old myocardial infarction, Exercise-redistribution-reinjection 201Tl |
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| English |
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| Title | Evaluation of Myocardial Fatty Acid Metabolism in the Area of Fill-in after Thallium Reinjection in Patients with Prior Myocardial Infarction |
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| Subtitle | Original Articles |
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| Authors | Ichiro MATSUNARI*, Susumu FUJINO**, Junichi TAKI***, Kenichi NAKAJIMA***, Takahiro NISHIKAWA*, Kenji ICHIYANAGI*, Norihisa TONAMI***, Kinichi HISADA*** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Departmen of Internal Medicine, Fukui Prefectural Hospital, ***Department of Nuclear Medicine, Kanazawa 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 | 2 |
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| Page | 147-153 |
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| Year/Month | 1995/2 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Myocardial fatty acid utilization in the area with thallium fill-in after reinjection was assessed using 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid (BMIPP). We studied 22 patients with prior myocardial infarction that revealed persistent defects on standard exercise-redistribution thallium imaging. In each patient, exercise-redistribution-reinjection thallium imaging was performed. Within two weeks of the thallium study, resting BMIPP imaging was performed 20 min after injection of BMIPP (148 MBq). Following qualitative analysis of the obtained thallium and BMIPP images, quantitative analysis was performed on the basis of relative regional uptake. Of 199 myocardial segments that showed persistent defects on exercise-redistribution images, 73 segments showed apparent fill-in on the reinjection images (fill-in positive), and the remaining 126 segments did not (fill-in negative). When BMIPP images were compared with the corresponding thallium reinjection images, reduced BMIPP uptake compared with thallium were frequently observed in the area of fill-in positive segments (65 of 73 segments, 89%). Quantitative analysis also showed decrease in BMIPP activity compared to thallium activity in the area of fill-in (49.7+-16.1 vs. 65.8+-16.0%, p<0.001). In contrast, only 24 of the 126 fill-in negative segments (19%) showed lower BMIPP uptake than thallium. These results suggest that impaired fatty acid utilization in the area of thallium new fill-in after reinjection already exists at resting condition. Thus, BMIPP imaging combined with exercise-redistribution-reinjection thallium imaging provides insights to understanding fatty acid utilization in ischemic but viable myocardium identified by thallium reinjection in patients with prior myocardial infarction. |
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| Practice | Clinical medicine |
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| Keywords | 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid, SPECT, Old myocardial infarction, Exercise-redistribution-reinjection 201Tl |
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