| Japanese |
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| Title | 急性心筋梗塞症における99mTc-sestamibi心筋SPECT経時的2回撮像の有用性 - 梗塞部rapid clearanceの臨床的意義 - |
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| Subtitle | 短報 |
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| Authors | 板金広*, 山岸広幸*, 大塚雅人*, 南俊郎*, 周藤弥生*, 破戸克規*, 東條修*, 奥町冨久丸*, 土師一夫* |
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| Organization | *大阪市立総合医療センター循環器内科 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 7 |
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| Page | 683-687 |
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| Year/Month | 1995/7 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」急性心筋梗塞症14例を対象に安静時99mTc-sestamibi(MIBI)心筋シンチグラムを経時的に2回撮像し, 梗塞部で高率にMIBIの洗い出しの亢進(rapid clearance)を認めた. また梗塞部でのrapid clearanceの意義を201TlCl(Tl)心筋シンチグラムと対比検討した. MIBI静注後90分に撮像した画像(MIBI-90)は再静注後のTlの画像と, MIBI静注後300分に撮像した画像(MIBI-300)は運動負荷後のTlの画像とよく一致した. MIBI-90は心筋viabilityを, またMIBI-300は急性期の危険域(risk area)を反映していると考えられた. 「I. はじめに」近年, 99mTc-sestamibi(MIBI)は広く虚血性心疾患の診断に用いられている. MIBIは心筋細胞内に取り込まれるとほとんど洗い出しされず心筋内に貯溜するとされている. 本研究では急性心筋梗塞症例の安静時MIBI心筋シンチグラムで, 梗塞部位のrapid clearanceが観察されることに注目し, 201TlCl(Tl)による運動負荷-再静注心筋シンチグラムと対比することにより, その臨床的意義を検討した. |
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| Practice | 臨床医学：一般 |
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| Keywords | Acute myocardial infarction, 99mTc-sestamibi, Rapid clearance. |
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| English |
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| Title | Clinical Value of Rapid Clearance in Resting Sestamibi Cardiac SPECT in Patients with Acute Myocardial Infarction |
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| Authors | Hiroshi ITAGANE, Hiroyuki YAMAGISHI, Masato OTSUKA, Shunro MINAMI, Yayoi SUTO, Katsunori HATO, Osamu TOJO, Fukumaru OKUMACHI, Kazuo HAZE |
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| Authors(kana) | |
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| Organization | Department of Cardiology, Osaka City General Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 7 |
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| Page | 683-687 |
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| Year/Month | 1995/7 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Resting 99mTc sestamibi (MIBI) SPECT and exercise-reinjection thallium-201 (Tl) SPECT were performed in fourteen patients with acute myocardial infarction (AMI). MIBI SPECT were obtained 90 min (MIBI-90) and 300 min (MIBI-300) after injection of 370 MBq of MIBI at rest. MIBI-90 and MIBI-300 were compared with exercise Tl imaging (Tl-EX) and Tl reinjection imaging (REINJ). Each SPECT image was divided into 22 segments and myocardial uptake was scored visually. Abnormal perfusion defects were observed in 94 myocardial regions. Worsening of the score was observed in 79 segments (84%) on MIBI-300 compared with MIBI-90. Total MIBI-300 uptake score per person was significantly greater than that at MIBI-90 (14.8+-8.6 vs. 7.7+-7.9, p=0.001). The concordance rate of defect score between MIBI-90 and REINJ was significantly higher than that between MIBI-300 and REINJ (55% vs. 17%, p=0.001). In nine patients without recanalization of an infarct-related artery, perfusion defects were seen in 74 segments. The concordance rate of defect scores between MIBI-300 and Tl-EX was significantly higher than that between MIBI-90 and Tl-EX (45% vs. 16%, p=0.001). In conclusion, rapid clearance of MIBI was observed frequently in patients with AMI. MIBI-90 and MIBI-300 may reflect myocardial viability and areas at risk for AMI, respectively. |
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| Practice | Clinical medicine |
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| Keywords | Acute myocardial infarction, 99mTc-sestamibi, Rapid clearance. |
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