| Japanese |
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| Title | 冠攣縮性狭心症の診断に123I-BMIPP心筋SPECTの後期像が有用であった一例 |
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| Subtitle | 《症例報告》 |
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| Authors | 田中勝巳*, 伊藤一貴*, 木下法之*, 中川雅夫*, 寺田幸治**, 梶田芳弘**, 杉原洋樹*** |
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| Authors(kana) | |
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| Organization | *京都府立医科大学第二内科, **公立南丹病院, ***京都府立医科大学放射線科 |
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| Journal | 核医学 |
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| Volume | 34 |
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| Number | 4 |
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| Page | 229-235 |
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| Year/Month | 1997/4 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」123I-BMIPP心筋SPECTの初期像では軽度の集積低下を示すのみであったが, 後期像で高度な局所集積低下を示した冠攣縮によるstunned myocardiumの1例を経験した. 症例は64歳の男性で, 主訴は安静時胸痛であった. 心臓カテーテル検査の前日深夜に心電図でSTの上昇を伴う頻回の胸痛発作を認めたが, 経時的な心筋逸脱酵素の上昇はなかった. 翌朝の冠動脈造影では有意狭窄はなく, 左室造影では前壁, 中隔, 心尖部にakinesisが認められた. 翌日の123I-BMIPP心筋SPECTの初期像では心尖部に軽度の集積低下を認めるのみであったが, 後期像では壁運動異常部位に一致して高度な集積低下が認められた. 内服治療3か月後の左室造影では壁運動異常は著明に改善し, エルゴノビン負荷で左前下行枝の近位部に完全閉塞が誘発された. 同時期の123I-BMIPP心筋SPECTでは, 初期像, 後期像とも集積低下はなかった. 本症例は, BMIPP後期像の利用の重要性を示唆した貴重な症例と考え報告した. |
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| Practice | 臨床医学：一般 |
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| Keywords | Vasospastic angina, Stunned myocardium, Myocardial SPECT, 123I-BMIPP, Reversed redistribution. |
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| English |
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| Title | Importance of the Delayed 123I-BMIPP Image for Detecting Myocardial Metabolic Abnormality Induced by Transient Myocardial Ischemia : A Case of Vasospastic Angina |
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| Subtitle | - Case Report - |
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| Authors | Katsumi TANAKA*, Kazuki ITO*, Noriyuki KINOSHITA*, Masao NAKAGAWA*, Kouji TERADA**, Yoshihiro KAJITA**, Hiroki SUGIHARA*** |
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| Authors(kana) | |
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| Organization | *Second Department of Medicine, Kyoto Prefectural University of Medicine, **Department of Internal Medicine, Nantan General Hospital, ***Department of Radiology, Kyoto Prefectural University of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 34 |
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| Number | 4 |
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| Page | 229-235 |
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| Year/Month | 1997/4 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | We experienced a case of 64-year-old man with stunned myocardium caused by vasospasm. Without enzymatic evidence of an acute myocardial infarction, the patient developed a prolonged chest pain with ST elevation in the electrocardiogram in the midnight before the day of coronary angiography. Coronary angiogram revealed no significant stenosis and left ventriculography demonstrated akinesis in the apicoanteroseptal region. Although initial images of 123I-BMIPP myocardium SPECT showed no significant decrease of uptake, delayed images revealed marked decrease of tracer uptake in the apicoanteroseptal region in which left ventriculography showed abnormal wall motion. After 3 months of medication, left ventriculography disclosed a marked improvement, and coronary spasm was evoked in the proximal portion of left anterior descending artery after intracoronary ergonovine provocations. At the same time, both initial and delayed images of 123I-BMIPP myocardial SPECT showed no significant decrease of tracer uptake. This patients was considered as a noteworthy case to understand the kinetics and metabolism of 123I-BMIPP in stunned myocardium. |
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| Practice | Clinical medicine |
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| Keywords | Vasospastic angina, Stunned myocardium, Myocardial SPECT, 123I-BMIPP, Reversed redistribution. |
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