@article{oai:u-ryukyu.repo.nii.ac.jp:02015857,
 author = {仲里, 政泰 and 加世田, 俊一 and 友利, 正行 and 丸岡, 雄二 and 柊山, 草志郎 and 勝山, 直文 and Nakazato, Masayasu and Kaseda, Shunichi and Tomori, Masayuki and Maruoka, Yuji and Fukiyama, Koshiro and Katsuyama, Naofumi},
 issue = {1},
 journal = {琉球医学会誌 = Ryukyu Medical Journal},
 month = {},
 note = {The purpose of this study was to evaluate clinical usefulness of exercise thallium-201 myocardial  single photon emission computed tomography (Tl-ECT) to detect organic coronary stenosis noninvasively.  One hundred thirty-one consecutive patients (34 to 79 years old, mean 58 y.o.) underwent  coronary angiography, and their findings were compared with those of Tl-ECT or exercise ECG.  In 100 patients who did not have myocardial infarction, sensitivity, specificity, predictive value  and accurcy of Tl -ECT to detect organic coronary stenosis (luminal narrowingmore than 50% in  coronary angiogram) were significantly higher than those of exercise ECG; 75% vs. 50% (p<0.05) , 75% vs. 44% (p<0.01), 63% vs 39% (p<0.01), and 75% vs. 46% (p<0.01), respectively. Peak heart  rate, peak systolic blood pressure, peak pressure rate product and percentage of the age-predicted  maximal heart rate at Tl-ECT test were not significantly different among patients with true positive  and false negative results of Tl-ECT, suggesting that false negative results of Tl -ECT were not  caused by lower achieved level of exercise in our study.  Among 19 patients with variant angina, 4 showed false positive results of Tl-ECT. In 3 of these  4 patients, Tl-ECT was repeated after administration of calcium channel blocker. Perfusion defect  observed at the first Tl-ECT test disappeared or became smaller in size in all 3 patients after the  treatment. Thus, exercise-induced coronary vasospasm might have caused the exercise-induced perfusion  defect in these patients with variant angina. In 31 patients with previous myocardial infarction, 25(81%) had perfusion defects, 6(19%) had  no perfusion defects. Sensitivity of Tl-ECT was 93%. There was no false positive result, while false  negative result were shown in 2 cases.  To evaluate myocardial viability in 28 patients (13 with previous myocardial infarction, 15 without it) in whom redistribution of Tl-ECT was incomplete or absent, thallium imaging at rest was performed in other day. Improvement of myocardial thallium imaging was observed in 13 patients.  We conclude that 1) Tl-ECT is more useful non-invasive test than exercise ECG for detection of  organic coronary stenosis, 2) false positive results of Tl-ECT in variant angina might be caused  by exercise-induced coronary vasospasm, 3) Tl-ECT at rest is indispensable to evaluate myocardial viability., 論文},
 pages = {74--91},
 title = {[原著］冠動脈病変の非侵嚢的検出法に関する研究 : 冠動脈造影検査と運動負荷タリウム心筋シンチグラフィ及び運動負荷心電図の比較},
 volume = {12},
 year = {1991}
}