心筋シンチグラムによる虚血性心疾患の冠血流分布に関する臨床的検討

Clinical evaluation of coronary perfusion with myocardial imaging in patients with ischemic heart disease

　多くの過程を経ながらも^1〜4），1959年Sonesら^5）が選択的冠動脈造影法を確立したことにより，その造影像が冠動脈の形態と機能検索上不可欠のものとなっている。一方，さらに末梢の心筋層における血流分布についても，¹³¹Csなどの核種が開発されたが，1975年，Lebo—witz^6,7），Straussら^8）により実証された²⁰¹Tlが臨床的にも定着をみるに到っている。

　さきに，筆者らは心筋シンチグラフィーによる臨床応用の一部を報告したが^9），今回，ECG gated scintigramを用いながら，その画像処理への検討を加え，さらに，薬効評価における有用性なども検索したので報告する。

Attempt was made to quantitatively analyse myocardial image with intravenously injected thallium-201 in patients with ischemic heart dis-ease. In the first place, evaluation of images from regions of interest seated in 3 perfusion beds supplied by main three coronary arteries was done. Secondly, uptakes from each of similar rectangles that was divided from regions of in-terest as mentioned above were calculated. Rela-tionship between scintigraphic ischemia (low up-take) and angiographic coronary stenoses was assessed and close correlation (90%) obtained. Ef-fect of coronary dilator (dilazep) on myocardial imaging was discussed. Data resulted in the quan-titative presentation according to the degree of the change in ischemia.

The consecutive observation of uptakes in rect-angles is likely to permit the behavior of coronary blood flow perfusion after injection of thallium. Moreover, in the equilibrium of isotope peak concentration was obtained in the middle of myo-cardium at end diastolic cardiac phase, whereas it was in the endocardium at the end systolic.