Watanabe M, Gotoh K, Nagashima K, Uno Y, Noda T, Nishigaki K, Takemura G, Kanoh M, Yasuda N, Ohno Y, Minatoguchi S, Fujiwara H
Second Department of Internal Medicine, Gifu University School of Medicine, Japan.
Ann Nucl Med. 2001 Feb;15(1):13-9. doi: 10.1007/BF03012125.
The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative 201Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq 201Tl at rest. We calculated the percent coefficient of variation of myocardial 201Tl counts [%CV(TI)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest 201Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size.
本研究的目的是阐明与扩张型心肌病（DCM）相关的哪些心肌组织学发现可在定量201Tl心肌单光子发射计算机断层扫描（SPECT）中得到体现。我们获取了21例DCM患者在静息状态下注射111 MBq 201Tl后10分钟和2小时的SPECT图像。我们计算了心肌201Tl计数的变异系数百分比[%CV(TI)]、洗脱率（WR）、WR的标准差[SD(WR)]、范围评分（ES）和严重程度评分（SS）。我们采用图像分析方法测量左心室心内膜活检标本中的纤维化百分比、心肌细胞百分比、纤维组织与心肌细胞组织的比例（F/My）、心肌细胞大小以及心肌细胞大小的标准差[SD(My)]。%CV(Tl)与纤维化百分比以及F/My相关。ES和SS也与F/My相关。SD(WR)与SD(My)之间存在显著相关性。目前的研究结果表明，静息201Tl SPECT的%CV(Tl)、ES和SS反映心肌纤维化，而洗脱标准差反映心肌细胞大小的分布。
