| Japanese |
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| Title | タリウム再静注法による心筋バイアビリティ評価 : 診断基準の違いによる壁運動改善予測能の比較 |
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| Subtitle | 原著 |
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| Authors | 藤野晋*, 松成一朗**, 村守朗***, 嵯峨孝*, 一柳健次*** |
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| Organization | *福井県立病院循環器内科, **ミュンヘン工科大学核医学科, ***福井県立病院放射線科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 12 |
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| Page | 1309-1317 |
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| Year/Month | 1996/12 |
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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」 左室全体あるいは局所壁運動異常を伴い, 冠動脈血行再建術を施行した25例を対象として, Tl再静注法における診断基準の違いによる左室壁運動異常改善予測能について検討した. 術前に局所壁運動異常を認め, 血行再建が確認された88領域中51領域で術後壁運動の改善を認め, 全体の平均左室駆出率は冠動脈血行再建術前の41±8%から術後45±10%へと増加した. Tl再静注像で50%以上の%uptakeを認めるものをバイアブルとする%uptake法の感度, 特異度, 正診率はそれぞれ96, 35, 70%で, 正常集積あるいは可逆性欠損をバイアブルとする可逆性欠損法ではそれぞれ67, 59, 64%であった. %uptake法は高感度であったが, 特異性に乏しく, 一方可逆性欠損法は感度では%uptake法に至らないものの, 特異性では優っていた. 以上より症例により二つの診断基準を使い分ける, あるいは組み合わせることが望ましいと考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Exercise-redistribution-reinjection 201Tl, SPECT, Coronary artery disease, Myocardial viability |
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| English |
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| Title | Residual Activity or Defect Reversibility on Stress-Redistribution-Reinjection 201Tl SPECT : Which Is the Better Marker of Myocardial Viability? |
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| Subtitle | Original Articles |
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| Authors | Susumu FUJINO*, Ichiro MATSUNARI**, Akira MURAMORI***, Takashi SAGA*, Kenji ICHIYANAGI*** |
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| Authors(kana) | |
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| Organization | *Department of Cardiology, ***Department of Radiology, Fukui Prefectural Hospita, **Department of Nuclear Medicine, Technical University of Munich |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 12 |
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| Page | 1309-1317 |
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| Year/Month | 1996/12 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Although both residual Tl activity and defect reversibility are used as a marker of myocardial viability on stress-redistribution-reinjection Tl (Tl-RI) imaging, it is not yet fully understood which marker better predicts reversible dysfunction after revascularization. The aim of this study was to assess the comparative efficacies of these criteria for prediction of functional recovery after revascularization. Twenty-five patients (LVEF 41%) who underwent successful revas-cularization were studied with Tl-RI SPECT and gated blood pool scintigraphy before revascularization. The gated blood pool study was repeated at mean 2 months after revascularization. The left ventricular myocardium was divided into 9 segments and the mean regional activities were calculated for each segment. In this study, two independent criteria were used as a viability index; (A) the presence of residual Tl activity (>50% of peak) on the final image (reinjection image), (B) reversible defect (>10% increase on the subsequent images) or normal Tl uptake (>80% of peak) on the initial image. Functional recovery occurred in 51 of 88 dysfunctional segments. The presence of residual Tl activity was a highly sensitive (96%) but poorly specific (35%) marker of reversible dysfunction, while a reversible defect or normal Tl uptake was a less sensitive (67%) but more specific (59%) predictor of functional recovery. In conclusion, defect reversibility provides unique information on myocardial viability which cannot be obtained by assessing residual Tl activity alone. |
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| Practice | Clinical medicine |
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| Keywords | Exercise-redistribution-reinjection 201Tl, SPECT, Coronary artery disease, Myocardial viability |
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