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Kokyu to Junkan Volume 33, Issue 10 （October 1985）

呼吸と循環 33巻10号（1985年10月発行）

Japanese English

研究

陳旧性心筋梗塞例における左室短軸断層心エコー図とSPECTの比較検討 Evaluation of regional wall motion and myocardial blood flow by two dimensional echocardiography and SPECT 前田岳 ¹ , 藤井諄一 ¹ , 岡部昭文 ¹ , 澤田準 ¹ , 相澤忠範 ¹ , 西村健司 ¹ , 佐藤廣 ¹ , 福田守人 ¹ , 渡辺凞 ¹ , 加藤和三 ¹ Takeshi Maeda ¹ , Junichi Fujii ¹ , Akifumi Okabe ¹ , Hitoshi Sawada ¹ , Tadanori Aizawa ¹ , Kenji Nishimura ¹ , Hiroshi Sato ¹ , Morihito Fukuda ¹ , Hiroshi Watanabe ¹ , Kazuzo Kato ¹ ¹心臓血管研究所 ¹The Cardiovascular Institute pp.1251-1255

発行日 1985年10月15日 Published Date 1985/10/15

DOI https://doi.org/10.11477/mf.1404204759

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Abstract 文献概要
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　回転型ガンマカメラを用いたタリウム201心筋エミッションCT（Tl 201-single photon emission computedtomography，以下SPECT）は非観血的に虚血性病変の検出や，その広がりを把握するうえで優れた検査法であり，近年急速に普及しつつある^1〜4）。一方，断層心エコー図（Two dimensional echocardiography，以下TDE）も非観血的に心臓の任意の断面の形態および動態を実時間で表示し得るため，ことに虚血性心疾患の診断や重症度の評価に広く用いられている。今回我々は，SPECTの左室短軸断面像とTDEの左室短軸断層図が，いずれもほぼ同じ左室短軸断面を描出していることに注目し，陳旧性心筋梗塞例においてTDEによる局所壁動態とSPE—CTによる局所心筋血流状態とを対比険討したので報告する。

Left ventricular (LV) regional wall motion deter-mined by two-dimensional echocardiography (TDE) was compared with regional myocardial flow evalu-ated with Tl-201 emission computed tomography (SPECT) in 32 patients with old myocardial infarc-tion. Short axis images of LV at the level of papil-lary muscle were obtained both by TDE and SPECT. LV walls in TDE and SPECT were divid-ed equally into S segments respectively, with reference point at the posterior end of the right side of the interventricular septum. Regional wall motion was evaluated as normal, mild-moderate hypokinesis, severe hypokinesis, akinesis and dyskinesis.

Abnormal wall motions were observed in 84 (95%) of 88 segments with defect of T1-201 uptake. Defect of Tl-201 uptake was demonstrated in 66 (69%) of 95 segments with severe hypokinesis, akinesis or dyskinesis and in 25 (96%) of 26 seg-ments with akinesis or dyskinesis. However, there were four cases who showed discrepancies between TDE and SPECT. In three of those four cases, LV wall motions were almost normal in the segments with small localized defect of Tl-201 uptake. In the other case with severe three vessels disease, defect of Tl-201 uptake was not demonstrated in some of the segments with akinesis, probably due to the diffuse decrement of Tl-201 uptake all over LV wall. The possibilities of these discrepancies should be taken into mind in such cases.

It is concluded that evaluation of regional wall motion and myocardial blood flow in each seg-ments is considered to be useful in elucidating the pathophysiology of myocardial abnormalities.