• Investigative Magnetic Resonance Imaging
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• 제8권1호
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• pp.17-23
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• 2004

목적 : 이차원 위상대조 자기공명영상을 이용하여 나이변화와 뇌실질 부피변화 및 혈관이상의 정도에 따른 총뇌혈류량의 변화를 알고자 하였다. 대상 및 방법 : 12명의 지원자를 포함한 73명을 대상으로 T2강조 영상과 Time-of-flight 방법의 자기공명혈관촬영과 이차원 위상대조 자기공명영상을 얻었다. 정상군은 지원자 12명과 자기공명영상 및 자기공명혈관촬영에서 정상소견을 보인 21명으로서 이들은 18-29세, 30-49세, 50-66세 군으로 나누었다. 비정상군은 T2강조영상의 뇌실질부피 변화정도와 자기공명 혈관촬영의 동맥경화 정도에 따라 mild reduction군(17명) , marked reduction군(12명)으로 나누었고, 뇌실질이 증가한 increased volume군(6명)과 Moya-moya군(5명)으로 분류하였다 뇌혈류는 위상대조 자기공명영상의 속도-혈류 곡선으로부터 양쪽 내경동맥과 추골동맥에서 측정하고 합하여 뇌의 총뇌혈류량으로 하였으며, 각군 사이의 혈류량을 비교 관찰하였다. 결과 정상군의 총뇌혈류량은 18-29세군은$12.0{\pm}2.1ml/sec$, 30-49세군은 $11.8{\pm}1.9m1/sec$, 50-66세군은 $10.9{\pm}2.2ml/sec$였다. 비정상군 중에서 mild reduction 군은 $9.5{\pm}2.5ml/sec$, marked reduction 군은 $7.6{\pm}2.0ml/sec$, increased volume군은 $7.3{\pm}1.2ml/sec$, Moya-moya군은 $7.0{\pm}1.1ml/sec$였다. 결론 : 총뇌혈류량은 나이 증가에 따라 감소하였고, 뇌실질부피 감소와 동맥경화 정도에 따라 감소하였으며 increased volume군과 Moya-moya군에서도 감소하였다. 이차원 위상대조 자기공명영상은 나이변화나 뇌실질의 부피변화와 혈관이상을 초래하는 다양한 뇌질환에서 총뇌혈류량을 관찰할 수 있는 유용한 방법이라고 생각된다.

• 대한핵의학회지
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• 제27권1호
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• pp.59-64
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• 1993

To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole $^{99m}Tc$-MIBI myocardial SPECT, we obtained $^{99m}Tc$-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole $^{99m}Tc$-MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex (LCX) and 8% for right coronary artery (RCA) territories. Lesions${\geqq}$50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns): specificity was 84.6% in men and 67.9% in women (P < 0.025). For individual coronary artery, the sensitivity in men and women was 87.7%, 81.8% for LAD; 78%, 83.3% for RCA and 52.2%, 46.7% for LCX (P=ns): the specificity was 80%, 40% for LAD (P<0.01), 82.5%, 68.4% for RCA, 88.9%, 86.4% for LCX (P=ns). The hemodynamic parameter after intravenous dipyridamole in men and women were significantly changed; the heart rate was increased and systolic, diastolic blood pressure was decreased. Adverse effects were reported in 58.8% of men and 72.7% in women (P=ns). The incidence of chest pain and headache were higher in women. There was no significant difference in the incidences of nausea, abdominal pain, dizziness, facial flushing, dyspnea. In conclusion, dipyridamole $^{99m}Tc$-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

• 대한핵의학회지
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• 제28권2호
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• pp.177-185
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• 1994

Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.