Japanese
Title肥大型心筋症と高血圧性肥大心の123I-BMIPP心筋SPECTの検討 - 201Tl心筋SPECT, Gd-DTPA造影MR所見との対比 -
Subtitle《原著》
Authors宮永一*, 川崎信吾*, 米山聡嗣**, 兵庫匡幸*, 神谷匡昭*, 高橋徹*, 國重宏*
Authors(kana)
Organization*松下記念病院第三内科, **朝日大学村上記念病院内科
Journal核医学
Volume34
Number2
Page85-93
Year/Month1997/2
Article原著
Publisher日本核医学会
Abstract「要旨」形態学的に心筋肥厚をきたす疾患, 高血圧性肥大心(HHD), 心尖部肥大型心筋症(APH), 肥大型心筋症(HCM)の3疾患に123I-BMIPP心筋SPECT, 201Tl心筋SPECT, Gd-DTPA造影核磁気共鳴図(MR)の3種の検査を施行し, 各疾患の画像診断上の所見を比較検討した. その結果BMIPPは3疾患群においてTlより広範な集積低下を示した. またHCMはHHDに比し広範な集積低下を心筋肥厚部で示した. Gd-DTPAによる造影効果もHCMに多く, 前壁, 中隔に造影効果を認めるのはHCMのみであった. 123I-BMIPP心筋SPECTの集積低下の出現部位はHCMでは前壁中隔接合部, APHでは心尖部にもっとも多く, HHDではほぼ平均的な分布を示した. 以上によりHCMにおいては脂肪酸代謝障害, 心筋変性がAPH, HHDより高度であることが示された. さらに201Tl心筋SPECT, Gd-DTPA造影核磁気共鳴図(MR)の検査の組み合わせにより病変の質, 広がり, 障害の程度などが把握でき臨床上有用と考えられた.
Practice臨床医学：一般
Keywords123I-BMIPP, 201Tl, Gd-DTPA, Hypertrophic cardiomyopathy, Hypertensive heart disease.
English
TitleClinical Evaluation of 123I-BMIPP Myocardial SPECT in Patients With Hypertensive Heart Disease and Hypertrophic Cardiomyopathy : Comparison with the Findings of 201Tl SPECT and Gd Enhanced Magnetic Resonance Imaging
Subtitle- Original Articles -
AuthorsHajime MIYANAGA*, Shingo KAWASAKI*, Satoshi YONEYAMA**, Tadayuki HYOUGO*, Tadaaki KAMITANI*, Toru TAKAHASHI*, Hiroshi KUNISHIGE*
Authors(kana)
Organization*Third Department of Internal Medicine, Matsushita Memorial Hospital, **Department of Internal Medicine, Murakami Memorial Hospital, Asahi University
JournalThe Japanese Journal of nuclear medicine
Volume34
Number2
Page85-93
Year/Month1997/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract123I-BMIPP SPECT (123I-BMIPP), 201Tl SPECT (201Tl), and Gd-DTPA enhanced magnetic resonance myocardial imaging (MR) were performed in patient groups with hypertensive heart disease (HHD), apical hypertrophic cardiomyopathy (APH), and hypertrophic cardiomyopathy without APH (HCM). SPECT was divided into 20 segments and each segment was scored as one of 4 grades (0=normal; 1=mildly decreased; 2=severely decreased; and 3=defect) according to the RI uptake. Gd enhancement in MR was interpreted visually. A decreased in the uptake of 123I-BMIPP showed in 54 of 141 hypertrophic (>13 mm, measured by ultrasonic cardiography) segments in HHD, in 32 of 66 in APH and in 103 of 207 in HCM respectively. Whereas 201Tl SPECT showed decreased uptake in 18 of 141 hypertrophic segments, in 18 of 66 in APH, and in 27 of 207 in HCM, respectively. 123I-BMIPP showed a higher incidence of these scintigraphic abnormalities than did 201Tl in the hypertrophic segments. And also in the hypertrophic segments, decreased in the uptake of 123I-BMIPP occurred more frequently in HCM than in HHD. In HCM, decreased 123I-BMIPP uptake appeared more frequently in segments 1, 2, 9, and 10 (antero-septal junction) than in other segments, but in APH, such decreases occurred more often in segments 17, 18, 19, and 20 (apex). Enhanced signal intensity with Gd-DTPA appeared in more segments in the HCM group than in the APH or HHD groups. We concluded that HCM had the most extensive and severe structural changes-including metabolic and ischemic changes-among three groups, and that the combination of these three examinations was useful for evaluating the characteristics of hypertrophic myocardium.
PracticeClinical medicine
Keywords123I-BMIPP, 201Tl, Gd-DTPA, Hypertrophic cardiomyopathy, Hypertensive heart disease.

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