Japanese
Title不整脈源性右室異形成症の左室波及病変の検出における123I-MIBG心筋イメージングの診断的意義
Subtitle原著
Authors高橋延和*, 石田良雄*, 前野正和*, 広瀬義晃*, 川野成夫*, 福岡周司*, 林田孝平*, 栗林幸夫*, 濱田星紀*, 山田直明*, 高宮誠*, 下村克朗**, 大江透***
Authors(kana)
Organization*国立循環器病センター放射線診療部, **心臓内科, ***岡山大学医学部循環器内科
Journal核医学
Volume33
Number1
Page57-67
Year/Month1996/1
Article原著
Publisher日本核医学会
Abstract「要旨」不整脈源性右室異形成症(ARVD)10例において, 左室への波及病変の検出における123I-MIBG(MIBG)SPECTの診断的意義を, 左室機能, 201Tl(Tl)心筋SPECT所見, 超高速CT(UFCT)およびMRI所見との比較により検討した. MIBG心筋像では, 4時間後に撮像した後期像で9例(90%)に左室心筋の局所欠損を認め, そのうち7例(70%)は右室に近接する心室中隔ならびにその周囲の左室領域に連続的な欠損を呈した. 左室駆出率(LVEF)から対象を, LVEF正常群5例, 低下群5例に分類した. LVEF正常群では, Tl集積低下例は2例であり, MIBG集積低下は4例であった. また, 集積低下の程度は, MIBGの方がより広範囲であった(Extent Score(ES) : 14±6 vs. 5±7, p<0.05). 一方, LVEF低下群では, 全例でMIBGとTlの集積低下が観察され, その集積低下度はMIBGの方が広範囲であり(ES : 42±12 vs. 25±3, p<0.05), またLVEF正常群よりも広範囲かつ高度であった(ES : 42±12 vs. 14±6, P<0.01, SS : 44±31 vs. 8±7, P<0.05). UFCTおよびMRIでは, 右室心筋の異常所見を4例で認めたが, 左室心筋の異常所見はLVEF低下群のうち左室壁運動異常を示した3例で認めた. 以上より, MIBG心筋像は, ARVDの左室への病変の波及を高感度にモニターし, またその異常の程度より, 左室障害の重症度評価に役立つと考えられる.
Practice臨床医学：一般
Keywords123I-metaiodobenzylguanidine, Arrhythmogenic right ventricular dysplasia, Thallium-201, Ultrafast computed tomography, Magnetic resonance imaging.
English
TitleSignificance of 123I-Metaiodobenzylguanidine SPECT for Detecting Left Ventricular Involvement in Patients with Arrhythmogenic Right Ventricular Dysplasia
Subtitle
AuthorsNobukazu TAKAHASHI*, Yoshio ISHIDA*, Masakazu MAENO*, Yoshiaki HIROSE*, Shigeo KAWANO*, Shuji FUKUOKA*, Kohei HAYASHIDA*, Sachio KURIBAYASHI*, Seiki HAMADA*, Naoaki YAMADA*, Makoto TAKAMIYA*, Katsurou SHIMOMURA**, Tohru OHE***
Authors(kana)
Organization*Department of Radiology, **Department of Cardiology, National Cardiovascular Cenyer, ***Department of Cardio vascular Medicine, Okayama University Medical School
JournalThe Japanese Journal of nuclear medicine
Volume33
Number1
Page57-67
Year/Month1996/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The right ventricle being primarily involved in ARVD, recent reports indicate the presence of histological and functional abnormalities in the left ventricle for some patients with ARVD. The aim of this study was to evaluate the significance of myocardial sympathetic dysfunction as an early sign of left ventricular (LV) involvement by 123I-MIBG(MIBG) SPECT and to compare the findings with those of 201TlCl(Tl) SPECT, radionuclide left ventriculography, ultrafast computed tomography(UFCT), magnetic resonance imaging (MRI) and echo-cardiography in 10 patients (pts) with ARVD. MIBG defects in LV regions were detected in 9 pts. Seven of the 9 pts showed MIBG defects in LV regions adjacent to RV. The subjects were divided into 2 groups based on left ventriculography, 5 with normal LVEF (>55%) and 5 with reduced LVEF. In the normal LVEF group, 4 pts showed MIBG defects and 2 pts showed Tl defects, and MIBG defects were larger than Tl defects (ES : 14+-6 vs. 5+-7, p<0.05). In reduced LVEF group, all of 5 pts showed MIBG and Tl defects, and MIBG defects were larger than Tl defects (ES : 42+-12 vs. 25+-3, p<0.05). In comparison with normal LVEF group, reduced LVEF group showed larger and more severe MIBG defects (ES : 42+-12 vs. 14+-6, p<0.01, SS : 44+-31 vs. 8+-7, p<0.05). UFCT and MRI showed abnormal findings indicating LV fatty infiltration in only 3 of reduced LVEF group. Thus, MIBG showed abnormal distributions in the left ventricle with the highest frequency in all these modalities. These results suggest that MIBG SPECT provides a sensitive marker for detecting LV involvement in ARVD. Also, the extent of MIBG distribution abnormalities is helpful in assessing the severity of left ventricular involvement in patients with ARVD.
PracticeClinical medicine
Keywords123I-metaiodobenzylguanidine, Arrhythmogenic right ventricular dysplasia, Thallium-201, Ultrafast computed tomography, Magnetic resonance imaging.

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