Japanese
Title冠動脈バイパス症例のグラフト血流量と心筋灌流との関連性 - グラフトDSAと201Tl心筋シンチグラフィによる評価 -
Subtitle原著
Authors松村憲太郎*, 中瀬恵美子*, 斎藤孝行**, 橘川信忠**, 原口隆志**
Authors(kana)
Organization*京都南病院循環器内科, **放射線科
Journal核医学
Volume33
Number2
Page131-142
Year/Month1996/2
Article原著
Publisher日本核医学会
Abstract「要旨」冠動脈バイパス症例のグラフト血流量および血流予備能をDSA(digital subtraction angiography)で測定し, 一方運動負荷およびdipyridamole負荷201Tl心筋シンチグラフィでグラフト領域の心筋灌流について比較検討した. 内胸動脈グラフトは大伏在静脈グラフトに比し有意にグラフト血流量が少なく, また血流予備能も小さかった. 201Tl心筋シンチグラフィでグラフト領域の灌流低下は運動負荷よりもdipyridamole負荷で高率に出現し, 内胸動脈グラフト群で50%に達した. いずれのグラフトでも201Tl心筋シンチグラフィで灌流異常のある症例は, ない症例に比しグラフト血流量が少なく, 血流予備能も有意に小さかった. 冠動脈バイパス症例ではグラフト開存例でもしばしば201Tl心筋シンチグラフィで灌流異常が出現する. 特に内胸動脈グラフトは血流予備能が小さいため, dipyridamole負荷でその傾向が強く見られる.
Practice臨床医学：一般
Keywords201Tl-myocardial scintigraphy, Digital subtraction angiography, Internal thoracic artery graft, Saphenous vein bypass graft, Dipyridamole.
English
TitleThe Graft Flow and 201Tl - Myocardial Scintigram in Patients with Saphenous Vein Graft or Left Internal Thoracic Artery Graft
SubtitleOriginal Articles
AuthorsKentaro MATSUMURA*, Emiko NAKASE*, Takayuki SAITO**, Nobutada KIKKAWA**, Takashi HARAGUCHI**
Authors(kana)
Organization*Department of Cardology, **Department of Radiology, Kyoto Minami Hospital
JournalThe Japanese Journal of nuclear medicine
Volume33
Number2
Page131-142
Year/Month1996/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]To evaluate myocardial perfusion in patients with saphenous vein graft(SVG)or internal thoracic artery graft(ITA-G), we studied 38 patients(14 : SVG, 10 males and 4 females, mean age 66+-9y-o ; 24 : ITA-G, 18 males and 6 females, mean age 64+-7 y-o)by digital subtraction angiography(DSA)of ITA-G or SVG, and thallium-201 myocardial perfusion scintigraphy on exercise or dipyridamole stress. The grafting sites were left anterior descending artery(LAD)in all patients. Normal controls(n=22)were defined by normal coronary angiogram and no evidence of myocardial ischemia. The graft flow and flow reserve on dipyridamole were measured by Rutishauser's fomula. The basal blood flow of native normal ITA, SVG and ITA-G were respectively 72+-24 ml/min, 51+-23ml/min, and 36+-20 ml/min. The basal ITA-G flow was significantly lower than SVG-flow(P<0.05). The flow reserves of SVG and ITA-G were respectively 2.32+-0.65 and 1.78+-0.59(p<0.02). The incidence of moderate hypoperfusion of thallium-201 SPECT was 14.3%in SVG and 12.5%in ITA-G on exercise stress, and 35%in SVG and 50%in ITA-G on dipyridamole stress. The incidence of reversible myocardial ischemia on dipyridamole stress was significant. The graft flow in patients with normal and abnormal thallium-201 SPECT were respectively 61+-21ml/min and 33+-15ml/min in SVG(p<0.01), 46+-19ml/min and 27+-16ml/min in ITA-G(p<0.02). The graft flow reserve were respectively 2.69+-0.38 and 1.65+-0.49 in SVG(p<0.001), 2.25+-0.40 and 1.31+-0.28 in ITA-G(p<0.001). We concluded that the basal blood flow and flow reserve of ITA-G were significantly lower than those of SVG The myocardial ischemia was occasionally documented by the thallium-201 myocardial SPECT on dipyridamole stress in patients with patent ITA-G.
PracticeClinical medicine
Keywords201Tl-myocardial scintigraphy, Digital subtraction angiography, Internal thoracic artery graft, Saphenous vein bypass graft, Dipyridamole.

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