Duchenne型進行性筋ジストロフィー心病変における心筋代謝，心交感神経機能をSPECTにより解析した1例

A Case Study:Alterations in regional myocardial metabolism and sympathetic nerve function in Duchenne muscular dystrophy studied by using single photon emission computed tomography

　Duchenne型進行性筋ジストロフィー患者の心病変について，心電図，心エコー，心プールシンチグラフィー，3種類のトレーサーを用いたイメージングをSPECTにより解析した．²⁰¹TlClの集積低下は心尖，後側壁に著明にみられ，この部位には¹²³I-BMIPPによる脂肪酸代謝障害がみられた．しかし，軽度の²⁰¹TlClの集積のみられた前中隔，後壁には¹²³I—BMIPPがよく集積し，心筋細胞の障害が軽いことが示唆された．¹²³I-MIBGによる交感神経機能は後側壁，心尖部は除神経の状態，前壁，前側壁，後壁はwash out亢進し刺激状態にあると考えられた．交感神経機能は心筋の部位により，また心筋細胞の変性の程度により異なることが示唆された．

The regional cardiac involvement in a case of Du-chenne muscular dystrophy was assessed by SPECT using ¹²³I-MIBG for sympathetic nerve function, ¹²³I-BMIPP for fatty acid metabolism and ²⁰¹TlCl for per-fusion. Distinct defect in ¹²³I-BMIPP and ²⁰¹TlCl was observed in the apex and posterior lateral wall. Although reduced uptake in TlCl was observed in the anterior septum and posterior wall, moderate uptake in BMIPP was detected in the region where normal fatty acid metabolism was supposed to remain. Accelerated washout of ¹²³I-MIBG was observed in the anterior wall, the anterior lateral wall, and the posterior wall, where the sympathetic nerve function would be expect-ed to be hyperactive. MIBG uptake was defective in the apex, and posterior lateral wall, where the sympathetic nerve was supposed to be in a denervated state.