99mTc-PYP，201Tl，123I-MIBG，111In-AM，123I-BMIPP心筋SPECT像が興味ある所見を示したPTCR成功例

Interesting PYP, 201Tl MIBG AM and BMIPP Myocardial SPECT Images in a Patient under Successful Reperfusion Therapy

　急性心筋梗塞に対して再灌流療法が成功し慢性期の左心駆出率が66％に保たれている例の^99mTc　pyrophosphate心筋像（PYP像），²⁰¹Tl心筋像（Tl像），¹²³I-metaiodobenzylguanidine心筋像（MIBG像），¹¹¹In-antimyosin Fab心筋像（AM像）や¹²³I-β-methyl iodophenyl pentadecanoic　acid心筋像（BMIPP像）を得た．第4病日のPYP像はTl像と前壁中隔で重なりを示した．第24病日のTl像では第4病日に認めた取り込み低下所見の改善を認めた．第48病日のMIBG像には広範な除神経領域を認めた．発生10カ月後のAM像では壁運動を認める心尖部中隔を主に取り込みを認めた．発生2年後のBMIPP像では心尖部中隔を主に取り込み低下とこの部位のwashout低下を認めた．この結果より心筋を壊死に至らせる虚血発作により心筋細胞にさまざまな障害が生じ，一部は陳旧期にまで持続する可能性が示された．心筋の病態評価に核医学的心筋像は有用な役を果たすことが明らかにされた．

Various types of radiopharmacons such as ²⁰¹Tl, ^99mTc-pyrophosphate (PYP), ¹²³I - metaiodobenzyl-guanidine (MIBG), ¹¹¹In-antimyosin Fab (AM) and ¹²³I -β-methyl iodophenyl pentadecanoic acid (BMIPP) were applied to a patient under successful reperfusion therapy. In the patient, elevated serum enzyme activity in the acute phase, and QS waves in precordial leads in the chronic phase were noted, ever though anterior wall movement was well maintained in the chronic phase.

On the 4th hospital day PYP uptake was noted at the apical region and the basal anteroseptal region.