| Japanese |
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| Title | 虚血性心疾患における123I-BMIPP心筋イメージングの臨床的意義 - Bull's-eye法を利用した定量的評価の有用性 - |
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| Subtitle | 原著 |
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| Authors | 高橋延和*, 石田良雄*, 広瀬義晃*, 川野成夫*, 福岡周司*, 林田孝平*, 高宮誠*, 野々木宏** |
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| Authors(kana) | |
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| Organization | *国立循環器病センター放射線診療部, **心臓内科 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 10 |
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| Page | 1089-1098 |
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| Year/Month | 1995/10 |
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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」虚血性心疾患(IHD)を対象として, 安静時123I-BMIPP(BMIPP)心筋SPECTを施行し, その虚血病変検出における定量的評価法の臨床的有用性について検討した. 冠動脈造影にてAHA分類75%以上の有意冠動脈狭窄病変を有する29例を対象として, 安静時BMIPP心筋SPECTを施行し, 視覚的評価法(V)と正常ブルズアイマップファイルのデータをもとに, 平均-2SD未満の有意な集積低下画素をblack-out表示した定量的評価法(Q)を比較検討した. 梗塞部領域(MI)ではVとQのsensitivityに差を認めないものの(100% vs. 100%), 非梗塞部領域(nonMI)ではsensitivityで改善を認めた(33% vs. 67%). nonMIにおいて, V, QともにBMIPPの欠損を認めない群(A群)に対して, Vでは欠損を認めないが, Qでは欠損を認める群(B群)とV, Qともに欠損を認める群(C群)では壁運動が低下する頻度が高く(2領域vs. 8領域:p<0.05, 2領域vs. 10領域:p<0.01), 冠動脈狭窄度が高値を示し(81±9% vs. 88±7%:p<0.05, 81±9% vs. 90±12%:p<0.05), より高度な虚血の存在が示唆された. 以上の結果よりIHDにおけるBMIPPの視覚的判定法では, 虚血病変を過小評価する問題が生じた. 視覚的評価法では異常が認められなくても, B群のように定量的評価法で欠損を示す領域では, 高度な虚血病変の存在が示唆されることから, IHD, 特に狭心症例の高度虚血病変の検出には, BMIPPの定量的評価法が有用であることが示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | 123I-BMIPP, Bull's-eye map, 201Tl, Ischemic heart disease. |
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| English |
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| Title | Detection of Myocardial 123I-BMIPP Distribution Abnormality in Patients with Ischemic Heart Disease Based on Normal Data File in Bull's-eye Polar Map |
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| Subtitle | Original Articles |
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| Authors | Nobukazu TAKAHASHI*, Yoshio ISHIDA*, Yoshiaki HIROSE*, Shigeo KAWANO*, Syuji FUKUOKA*, Kohei HAYASHIDA*, Makoto TAKAMIYA*, Hiroshi NONOGI** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Department of Cardiology, National Cardiovascular Center |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 10 |
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| Page | 1089-1098 |
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| Year/Month | 1995/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Visual interpretation of 123I-BMIPP (BMIPP) myocardial images has difficulties in detecting mild reduction in tracer uptake. We studied the significance of the objective assessment of myocardial BMIPP maldistributions at rest by using a Bull's-eye map and its normal data file for detecting ischemic heart disease. Twenty nine patients, 15 with prior myocardial infarction and 14 with effort angina were studied. The initial 15-min BMIPP image was evaluated by visual analysis and by generating the extent Bull's-eye map which exhibits regions with reduced % uptake under mean-2SD of 10 normal controls. The sensitivity for determining coronary lesions in non-infarcted myocardial regions with the extent map was superior to that with visual analysis (67% vs. 33%). In the regions supplied by the stenotic coronary artery, those which showed visually negative but positive in the map and which showed positive in both had higher incidence of wall motion abnormalities and severe coronary stenosis than those with normal findings in both. These results suggest that the objective assessment based on the normal data file in a Bull's-eye polar map is clinically important for improving the limitation of the visual interpretation in 123I-BMIPP imaging. |
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| Practice | Clinical medicine |
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| Keywords | 123I-BMIPP, Bull's-eye map, 201Tl, Ischemic heart disease. |
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