Japanese
Title虚血性心筋症と非虚血性拡張型心筋症の鑑別における123I-BMIPPの有用性
Subtitle原著
Authors広瀬義晃*, 石田良雄*, 林田孝平*, 川野成夫*, 福岡周司*, 植原敏勇**, 西村恒彦**
Authors(kana)
Organization*国立循環器病センター放射線診療部, **大阪大学医学部トレーサ情報解析
Journal核医学
Volume33
Number1
Page19-25
Year/Month1996/1
Article原著
Publisher日本核医学会
Abstract「要旨」冠動脈の高度な狭窄病変により生じた虚血性心筋症(ICM)と, 冠動脈病変以外の原因による非虚血性拡張型心筋症(NCM)との鑑別における123I-BMIPPシンチグラフィの有用性を201Tl心筋シンチグラフィと比較しつつ検討した. 対象は, ICM 9例とNCM 15例の計24例(男女比18:6, 平均年齢53歳)である. 123I-BMIPPと201Tl心筋SPECT像を20セグメントに分割し, RIの集積の程度を正常(0)から欠損(3)の4段階にスコアー化し, 半定量的に解析した. 全セグメントのスコアーの和は, ICMでは123I-BMIPPが35.5±14.4, 201Tlが27.6±14.6, NCMではそれぞれ14.1±9.3と12.1±7.4で, ICMで有意に高いスコアーであった. 集積の異常を認めたセグメント数は, ICMでは123I-BMIPPが15.4±3.7, 201Tlが13.5±5.7, NCMでは, それぞれ9.7±5.3と9.9±5.3で, ICMにおいて123I-BMIPPの集積異常の拡がりが201Tlよりも広かった. さらに, 異常セグメントのdefect scoreの平均はICMでは, 123I-BMIPPが2.25±0.52, 201Tlが1.92±0.51, NCMでは, それぞれ1.36±0.36と1.24±0.42で, ICMにおいて有意に障害の程度が強かった. このように, ICMはNCMに比べ, 脂肪酸代謝, 血流ともに低下し, 123I-BMIPPと201Tlの解離も大であった. 以上より, 123I-BMIPPは両者の鑑別に有用と考えられる.
Practice臨床医学：一般
Keywords123I-BMIPP, Ischemic cardiomyopathy, Nonischemic dilated cardiomyopathy, Differential diagnosis.
English
TitleUsefulness of 123I-BMIPP Scanning for Distinction of Ischemic from Nonischemic Dilated Cardiomyopathy
Subtitle
AuthorsYoshiaki HIROSE*, Yoshio ISHIDA*, Kohei HAYASHIDA*, Shigeo KAWANO*, Shuji FUKUOKA*, Toshiisa UEHARA**, Tsunehiko NISHIMURA**
Authors(kana)
Organization*Department of Radiology, National Cardiovascular Center, **Tracer Kinetic Analysis, Osaka University Medical School
JournalThe Japanese Journal of nuclear medicine
Volume33
Number1
Page19-25
Year/Month1996/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] To determine if imaging of blood flow(using 201Tl) and fatty acid (using 123I-BMIPP) with SPECT can distinguish cardiomyopathy of coronary artery disease from nonischemic dilated cardiomyopathy, 24 patients with severe left ventricular dysfunction were evaluated. The origin of left ventricular dysfunction had been previously determined by coronary angiography to be ischemic (9 patients) or nonischemic (15 patients). Images were visually analyzed by three observers on a graded scale (score 0 ; normal, 1 ; mild uptake reduction, 2 ; severe uptake reduction, and 3 ; defect) in 20 left ventricular segments revealed higher defect score in ICM compared with NCM for 123I-BMIPP (35.5+-14.4 versus 14.1+-9.3, p<0.0005) and 201Tl (27.6+-14.6 versus 12.1+-7.4, p<0.005). The defect score/segment ratio also revealed higher value in ICM compared with NCM for 123I-BMIPP (2.25+-0.52 versus 1.36+-0.36, p<0.0001) and 201Tl (1.92+-0.51 versus 1.24+-0.42, p<0.005). Myocardium of ICM is more severely damaged than that of NCM. Thus, noninvasive SPECT imaging with 123I-BMIPP is helpful in distinguishing patients with severe left ventricular dysfunction secondary to coronary artery disease from those with nonischemic cardiomyopathy.
PracticeClinical medicine
Keywords123I-BMIPP, Ischemic cardiomyopathy, Nonischemic dilated cardiomyopathy, Differential diagnosis.

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