Japanese
Title心電図同期99mTc-MIBI心筋断層像による左室収縮動態の検討 - 多方向長軸断層像による試み -
Subtitle原著
Authors成田充啓*, 栗原正*, 新藤高士*, 宇佐美暢久*, 本田稔**
Authors(kana)
Organization*住友病院内科, **アイソトープ検査部
Journal核医学
Volume32
Number11
Page1227-1239
Year/Month1995/11
Article原著
Publisher日本核医学会
Abstract「要旨」安静時に心電図同期99mTc-MIBI心筋断層像(G-SPECT)を撮像, 左室各部で1心拍での心筋カウントの経時的変化を観察した. 収縮に伴う心筋カウントの増加率(%CC)は21例でM-モード心エコーで求めた中隔, 後壁の収縮に伴う壁厚増加率(%WT)とr=0.86(p<0.01)の相関を示した. 健常(N)10例, 心筋梗塞(MI)9例で多方向長軸断層像を作成, 心尖部を含む左室17箇所で%CC, ピークカウント(PC)の出現時期を見た. Nで%CCは心尖部, 左室中央部, 心基部に至るにつれ有意の低下を示し, 中隔部では側壁部より低値を示すため, 各区域毎に%CCの正常値を決定した. MIではNと異なり各区域でのPC出現のばらつきが大で, 梗塞域で遅れを示した. MIにおいて%CCの低下は心筋灌流イメージングでみた梗塞域の91%に出現, さらに運動負荷による虚血域の83%, 梗塞のない脂肪酸代謝低下部の89%でも低下を示した. 安静時での%CCの低下は壊死部のみでなくcompromized myocardiumをも反映し, G-SPECTは有用な情報をもたらした.
Practice臨床医学：一般
Keywords99mTc-MIBI, ECG gated SPECT, Multiple long axial tomography, Percent count change.
English
TitleAssessment of Left Ventricular Contraction Kinetics by ECG-Gated Myocardial SPECT with 99mTC-MIBI : A New Attempt with Multi-plane Long Axial Tomography
Subtitle
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Takashi SHINDOH*, Masahisa USAMI*, Minoru HONDA**
Authors(kana)
Organization*Department of Internal Medicine, Sumitomo Hospital, **Department of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume32
Number11
Page1227-1239
Year/Month1995/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]To investigate left ventricular (LV) contraction kinetics, we performed ECG gated myocardial tomography (gated-SPECT) with 99mTc-MIBI (99mTc methoxy-2-isobutyl isonitrile) at rest. Data were obtained from 32 views and R-R interval was divided into 16. To clarify whether myocardial count change during systole (%CC) reflected LV wall thickening (%WT), we compared septal and posterior %CC in short axis image with %WT which were obtained by echocardiography. And %CC correlated well with %WT(r=0.86, p<0.01). In order to assess myocardial contraction kinetics in various parts of LV, multi-plane long axial tomograms were constructed in 10 normal subjects and 9 patients with myocardial infarction (MI). By multi-plane long axial tomography, LV was divided into 17 segments. In each segment %CC was calculated from time activity curves of myocardial count of 99mTc-MIBI. And the disparity of the appearance of peak count in each segment was also observed. In normal subjects %CC was greatest at apex and they decreased from apex to cardiac base. Besides %CC at lateral segments was greater than that in septal segments. Normal range of %CC was determined segment by segment. In normal subjects the intervals from ECG R-wave to peak count were not different in each segment. But in patients with MI they distributed in wide range and prolonged intervals were observed in segments with rest perfusion defect (infarcted segment). In patients with MI decreased %CC was observed in 91% of infarcted segments, in 83% of the segments with exercise induced ischemia and in 89% of the segments with 123I-BMIPP defects. These results indicated decreased %CC represented viable but compromized myocardium as well as necrotic myocardium. In gated-SPECT we obtained useful informations in addition to myocardial perfusion. But it took more than 30 minutes to perform. More experience will be necessary to ascertain the value of this technique.
PracticeClinical medicine
Keywords99mTc-MIBI, ECG gated SPECT, Multiple long axial tomography, Percent count change.

【全文PDF】