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I Matsunari

Publications and source records attributed to I Matsunari.

51 records · Page 3Linked to original sources
PubMed1994

[123I-BMIPP whole-body scintigraphy in relation to left ventricular ejection fraction].

Heart uptake and clearance of 123I-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid (BMIPP) by whole-body scintigraphy in relation to left ventricular injection fraction (LVEF) was evaluated in 19 patients with myocardial infarction. At 45 and 210 min after injection, anterior whole-body images were obtained with a single-headed gamma camera system. In each patient, gated blood pool scintigraphy was also performed, and LVEF was calculated. Percent washout from the heart from the 45 to the 210 min imaging positively correlated with LVEF (r = 0.61, p < 0.01), although percent uptake and count density of the heart at 45 min imaging did show any positive correlation with LVEF (r = -0.10 and r = 0.35, respectively). The count density did not correlated with the percent washout (r = 0.32, p = 0.18). Thus, some relationship between LVEF and washout rate of BMIPP from the heart was suggested by analysis of BMIPP whole-body scintigraphy in patients with myocardial infarction.

Adult↗
PubMed1994

Kinetics of iodine-123-BMIPP in patients with prior myocardial infarction: assessment with dynamic rest and stress images compared with stress thallium-201 SPECT.

UNLABELLED: Myocardial kinetics of 123I-labeled 15-(p-iodophenyl)3R, S-methylpentadecanoic acid (BMIPP) were evaluated with dynamic SPECT, and stress and rest BMIPP images were directly compared in conjunction with stress 201Tl. METHODS: We studied 26 patients with prior myocardial infarction. Two minutes after injection of BMIPP, dynamic data acquisition with a three-headed SPECT was started and continued for 12 min. Conventional SPECT images were obtained at 20 min and 3 hr after injection. On a separate day, exercise, stress 201Tl SPECT was performed at 10 min and 3 hr after injection. Exercise stress-BMIPP imaging was performed in 15 of the patients, and static SPECT images were obtained. RESULTS: With dynamic SPECT, early clearance of BMIPP from the myocardium was observed in the segments with reversible 201Tl defects, suggesting enhanced contribution of backdiffusion from BMIPP. In myocardial segments with reversible 201Tl defects, 20-min BMIPP images showed a higher frequency of reduced uptake when compared to 3-hr 201Tl (90/163) imaging. CONCLUSION: With BMIPP dynamic SPECT, an enhanced contribution of backdiffusion in the early phase from ischemic myocardium was suggested. When exercise stress BMIPP images were obtained, a more severe defect was observed than on rest BMIPP and stress 201Tl imaging, possibly due to decreased coronary blood flow and impaired fatty acid uptake induced by ischemia during exercise.

Exercise Test↗
PubMed1993

Regional uptake of iodine-125-metaiodobenzylguanidine in the rat heart.

Regional uptake of iodine-125-metaiodobenzylguanidine ([125I]MIBG) was evaluated in normal (n = 12) and reserpinized (n = 12) rat hearts. At 15 min and 1, 3 and 6 h after injection of [125I]MIBG, tissue activities were calculated for the right ventricular myocardium (RV), the whole left ventricular myocardium (whole LV), the epicardial layer of the left ventricular myocardium (Ep LV), the endocardial layer of the left ventricular myocardium (En LV), the basal segment of the left ventricular myocardium and the apical segment of the left ventricular myocardium. The uptake of [125I]MIBG at 6 h after injection in the normal rat heart was higher in RV than in whole LV (0.45 +/- 0.09% vs 0.30 +/- 0.06% kg dose/g), and in Ep LV than in En LV (0.32 +/- 0.07% vs 0.25 +/- 0.05%). In the reserpinized rat heart, the difference in the uptake between Ep LV and En LV was smaller. This suggests that the difference in the regional [125I]MIBG uptake might reflect different intravesicular uptake in the layers of the heart. To our knowledge, the low uptake in the endocardial layer was a new finding which seems to indicate a difference in innervation between the epicardial and endocardial layers of the left ventricle in the rat heart. Autoradiographic study also showed the low uptake of [125I]MIBG in the endocardial layer, while homogeneous perfusion was observed with thallium-201, supporting the tissue uptake study. Thus, the endocardial and epicardial layers of the left ventricle in the rat heart were considered to be differently innervated.

3-Iodobenzylguanidine↗
PubMed1993

[Evaluation of early kinetics of 123I-BMIPP in patients with ischemic heart disease].

Early kinetics of 123I-BMIPP was evaluated in 200 left ventricular myocardial segments from 10 patients with old myocardial infarction, employing dynamic SPECT. Dynamic SPECT acquisition was performed from 2 minutes to 14 minutes after injection of 123I-BMIPP. Conventional static SPECT with 123I-BMIPP (BM-S) at 20 min after injection and delayed image from stress 201Tl SPECT (Tl-RD) were visually evaluated by dividing each myocardial segment into the following four groups, NL (the segments with normal radioactivity in BM-S and Tl-RD), Tl < BM (the segments with reduced radioactivity in Tl-RD compared with BM-S), Tl > BM (the segments with reduced radioactivity in BM-S compared with Tl-RD) and Tl = BM < NL (the segments with equally reduced radioactivity in BM-S and Tl-RD). In the dynamic SPECT, washout rate (WR) from 2-4 to 12-14 minutes images was calculated. The WR of Tl > BM group (12.9 +/- 15.5% (mean +/- SD), 55 of 200 segments) was significantly higher than those of NL (-8.6 +/- 11.9%, 95 of 200 segments), Tl = BM < NL (-0.6 +/- 16.0%, 45 of 200 segments) and Tl > BM (-4.4 +/- 9.2%, 5 of 200 segments) groups. This high WR of Tl > BM group may reflect "back diffusion" from myocardium in early phase after injection of 123I-BMIPP.

Adult↗
PubMed1991

[Cardiac response to exercise before and after coronary artery bypass grafting: evaluation by continuous ventricular function monitor].

Cardiac response to exercise was evaluated with continuous ventricular function monitor (VEST) with cadmium telluride detector. Thirty-nine patients (30 male and 9 female, aged 57 +/- 8, 23 had old myocardial infarction) were monitored with VEST during and after supine ergometer exercise before and 4 weeks after coronary artery bypass grafting (CABG). Left ventricular ejection fraction (EF) responses were classified into 4 types; type A showed EF increase greater than 5% till end of exercise, type B demonstrated initial increase followed by decrease in EF, type C revealed no significant EF change, type D showed continuous EF decrease. Before CABG, each EF response type A, B, C, and D consisted of 4, 2, 12, 21 patients respectively and after CABG each type included 18, 10, 9, 2. The EF change from rest to peak exercise (delta EF-Ex) improved from -6.4 +/- 8.8% to 5.0 +/- 7.4% (p less than 0.001) after CABG. All patients showed rapid EF increase after exercise or "EF overshoot" (EF-OS). After CABG, the EF change from rest to EF-OS (delta EF-OS) and time to EF-OS (T-OS) were improved from 9.9 +/- 5.2% to 14.9 +/- 5.3% (p less than 0.001) and 162 +/- 86 sec to 80 +/- 48 sec (p less than 0.001) respectively. Type A, B patients showed higher delta EF-OS and shorter T-OS than type C, D patients, suggesting EF overshoot was contingent upon cardiac function during exercise. After CABG, in patients with myocardial infarction, T-OS shortened but delta EF-OS showed less improvement than patients without infarction, suggesting loss of myocardium hampered EF-OS.

Aged↗
PubMed1991

[Basic evaluation of an ambulatory ventricular function monitor with a a cadmium telluride detector].

The reliability of a new ambulatory ventricular function monitor (VEST) with cadmium telluride (Cd-Te) detector was validated. No counting loss was observed under 20 kcps. In phantom study, more than 200 ml with 6 cm distance from the detector and more than 300 ml with 6-12 cm distance, underestimation of volume was observed. Ejection fraction (EF) calculated in phantom study showed close value to the true EF in 50-400 ml of end-diastolic volume. In 10 patients, 1-2 cm detector shift toward right upper, upper and left showed underestimation of EF. Good correlation of gamma camera EF (X) and VEST EF (Y) was obtained (Y = 0.96X + 3.6(%), n = 37, r = 0.93, p less than 0.001). EF change from rest values, obtained from each comparable exercise and post exercise stage by gamma camera (X) and VEST (Y), showed good correlation (Y = 0.95X + 0.8, n = 20, r = 0.85, p less than 0.001). In conclusion Cd-Te VEST was considered as a reliable EF measurement technique similar to gamma camera.

Cadmium↗
PubMed1991

Dynamic acquisition with a three-headed SPECT system: application to technetium 99m-SQ30217 myocardial imaging.

A method for SPECT data acquisition, "continuous repetitive rotation acquisition," was developed with a high-sensitivity three-headed SPECT system. The method was applied to the dynamic imaging of 99mTc-SQ30217, a new myocardial imaging agent. After acquisition and reconstruction of SPECT data every minute, projection images at arbitrary intervals were used for tomographic reconstruction to determine the best timing of SPECT imaging in 99mTc-SQ30217. Based on a comparison of several possible acquisition intervals, SPECT data acquisition within 9 min after injection is recommended because of high myocardial uptake (myocardium-to-lung ratio, 2.83 +/- 0.42 (mean +/- s.e.m.) at 3-6 min) and relatively low hepatic uptake (myocardium-to-liver ratio, 0.85 +/- 0.13 at 3-6 min). The rate constant of the clearance of 99mTc-SQ30217 from the myocardium obtained by SPECT was: k1 = 0.249 +/- 0.050 per min (average half-life = 2.8 min) and k2 = 0.012 +/- 0.004/min (average half-life = 58 min). The continuous repetitive rotation acquisition SPECT study appears useful for imaging SQ30217 with its rapidly changing myocardial distribution.

Adult↗
PubMed1990

Evaluation of inferior mesenteric vein blood flow circulation with per-rectal administration of thallium-201 and technetium-99m pertechnetate.

We administered both per-rectal thallium-201 (201Tl) and technetium-99m pertechnetate (99mTc) to patients with liver diseases in order to understand the abnormalities of inferior mesenteric vein (IMV) blood flow circulation. As 201Tl heart-to-liver uptake ratio (H:L), reflecting the degree of portal-systemic shuntings (PSS), increased, the visualization of IMV in general became poor on 99mTc scintigrams. 201Tl H:L in the group with no visualization of IMV on 99mTc scintigrams was significantly higher than in the group with clear visualization of IMV (p less than 0.001). However, there were patients who showed IMV visualization among those with high 201Tl H:L. In these patients, it was considered that IMV blood flowed in the normograde direction, escaping mainly through PSS at the upper part of the portal system, and resulting in elevated H:L. In the patients without IMV visualization, IMV blood flowed in the retrograde direction, escaping mainly through collaterals at the lower part of IMV. Inferior vena cava (IVC) was visualized on 99mTc scintigrams in some patients without IMV visualization, indicating the presence of collaterals from the distal part of IMV to IVC. Per-rectal studies using these two radiotracers can afford us useful informations on the abnormalities of IMV blood flow hemodynamics in patients with liver diseases.

Adult↗
PubMed1990

[Evaluation of factor analysis and other functional images in exercise gated blood-pool study].

Factor analysis, a new method of functional imaging, has been applied to cardiovascular nuclear medicine. Because of the difficulty of its interpretation, it has not been popular as a method for detecting abnormal wall motion. The purpose of this study was to evaluate the usefulness of factor analysis in exercise gated blood-pool study in patients with ischemic heart disease. In our factor analysis, left ventricular region of interest (LVROI) was extracted to exclude the surrounding radioactivities. The new method was compared with 1) the conventional factor analysis using whole region (whole ROI method), and with 2) the other functional images, i.e. stroke volume, ejection fraction and phase images. At first we tried 3-factor analysis of the LVROI method, which resulted in many uninterpretable factors. Whereas in 2-factor analysis no uninterpretable factors were extracted. In comparison with cine-mode display, the LVROI method with 2-factor analysis showed the best sensitivity (85%) and specificity (100%). In exercise gated blood-pool study, it became easier to detect abnormal wall motion by comparing the factor image at exercise with resting image. In conclusion, the 2-factor analysis using the LVROI method greatly improved the limitation of conventional factor analysis, and will be useful in detecting wall motion abnormality in patients with ischemic heart disease.

Adult↗
PubMed1990

[Evaluation of hypertrophic cardiomyopathy with 123I-metaiodobenzylguanidine].

Single-photon emission computed tomography was performed in 29 patients with hypertrophic cardiomyopathy (HCM) using 123I-metaiodobenzylguanidine (MIBG). Segmental myocardial uptake of MIBG and 201T1 was calculated in 21 patients with primary HCM without history of hypertension. Septal thickness was measured by echocardiography and the relationship to septal MIBG uptake was studied. Initial MIBG uptake and 201T1 uptake showed positive correlation with the septal thickness (R = 0.581, p = 0.0058 and R = 0.677, p = 0.0007). When the septal MIBG uptake was divided by the corresponding 201T1 uptake (MIBG/T1), both the early and delayed MIBG/T1 showed negative correlation with the septal thickness (R = -0.485, p = 0.0255 and R = -0.535, p = 0.0125). Significant positive correlation was observed between septal MIBG clearance and the thickness (R = 0.510, p = 0.0182). In patients with severe septal hypertrophy (greater than 20 mm), the MIBG clearance was significantly higher compared with less hypertrophic (less than or equal to 20 mm) group (13.4 +/- 8.0%/hr vs. 3.2 +/- 4.7%/hr, p = 0.0028). Thus, MIBG was useful for the evaluation of sympathetic innervation and activity in HCM. The MIBG clearance and uptake in conjunction with 201T1 study seemed to reflect the severity of hypertrophy in HCM.

3-Iodobenzylguanidine↗
PubMed1989

[Evaluation of ischemia by exercise stress Tl-201 myocardial SPECT in silent and symptomatic ischemia].

Forty patients with ischemic heart disease confirmed by coronary arteriography were performed Tl-201 stress myocardial scintigraphy using SPECT. Fifteen patients had anginal attack during exercise Tl-201 myocardial perfusion study (symptomatic group), and 25 patients had horizontal or downsloping ST segment depression more than 0.1 mV without angina (asymptomatic group). The washout maps were derived from circumferential profile analyses of tomographic short-axis slices, and the data were plotted as a bull's eye map. The patient's washout map was compared with the lower limit of normal (mean--2 SD), and the extent and severity scores were calculated. On visual analysis 87% (13/15) of symptomatic patients showed redistribution, while only 56% (14/25) of asymptomatic patients showed redistribution (p less than 0.05). The extent score was significantly higher in the symptomatic group than in asymptomatic group (37.2 + 23.6 vs. 19.6 + 20.8, p less than 0.05), but severity score was slightly higher in symptomatic group (56.1 + 59.4 vs. 30.0 + 54.8, NS). In conclusion, symptomatic ischemia may be more severe than asymptomatic one and the degree of ischemia may be one of the factors that determine the presence of angina during ischemia.

Adult↗
PubMed1989

[Evaluation of ischemic heart disease by thallium-201 washout-rate map using SPECT].

In thallium-201 myocardial perfusion scintigraphy, washout rate (WR) has been used for the evaluation of the severity of ischemic heart disease (IHD). The WR was calculated from the polar map (Bull's-eye display) of myocardial perfusion using SPECT. To analyze the abnormality of WR map, we computed the extent and severity scores of WR. Applications of two types of standards, absolute and relative standards from control group (n = 16), were compared. The multiple regression analysis showed that the global WR was a function of the severity of coronary artery stenosis and exercise level, i.e. WR (%) = -2.38 X (number of stenotic artery) + 0.093 X (rate-pressure product/100) + 19.7 (n = 62, r = 0.63). Thus in evaluating the severity of IHD by absolute WR, the correction of WR was necessary according to the exercise level. Whereas, to evaluate the score of WR abnormality in polar map, the relative standard separated each group with different number of stenotic artery better than absolute standard did. In conclusion, calculation of WR score from relative standard is recommended for the analysis of polar WR map, although absolute global WR is useful for the evaluation of severity of coronary artery disease.

Coronary Disease↗
PubMed1989

[Separate evaluation of beta-methyl fatty acid uptake and perfusion in rat myocardium].

The kinetics and distribution of I-125 beta-methyl iodophenyl pentadecanoic acid (BMIPP) in rat's heart were studied for separate evaluation of perfusion and metabolism. Tl-201 and BMIPP were simultaneously injected. The experimental groups consisted of control (C), glucose (G) and sodium lactate loaded group (L). In C, myocardial uptake at 5 minutes after BMIPP injection was 3.60% ID/g and remained constant up to 60 minutes. The myocardium/lung ratio (2.44) and the myocardium/muscle ratio (4.55) of BMIPP were almost equal to those of Tl-201. But myocardium/liver ratio was low (1.31). In G, myocardial uptake of BMIPP (1.94 +/- 0.36% ID/g) and g-BMIPP/Tl (0.31 +/- 0.03) at 15 minutes after injection were significantly decreased (p less than 0.001) than those of C (3.16 +/- 0.18% ID/g and 0.48 +/- 0.05). In L. myocardial perfusion was decreased and g-BMIPP/Tl (0.73 +/- 0.14) was significantly higher (p less than 0.01) than those of C. Coefficient of variance of the density within a myocardium, and the ratio of inner to outer layer of myocardium (I/O ratio) were calculated from autoradiogram by videodensitometry. The myocardial distribution of BMIPP was more inhomogeneous, and the I/O ratio was lower than that of Tl-201, although these were not specific for metabolic interventions. In conclusion BMIPP is suitable for SPECT imaging and dual nuclide imaging by BMIPP and Tl-201 will provide informations about myocardial fatty acid metabolism and perfusion.

Animals↗
PubMedDate not supplied

Attenuation-corrected rest thallium-201/stress technetium 99m sestamibi myocardial SPECT in normals.

BACKGROUND: Rest thallium-201/stress technetium 99m sestamibi protocol is widely used in the clinical setting. Although attenuation correction (AC) represents an important recent development in cardiac single photon emission computed tomography (SPECT) imaging, adjacent extracardiac activity can affect the myocardial count density distribution on AC images, particularly with 201Tl. The aims of this study were to compare normal distribution between AC rest 201Tl and stress 99mTc-sestamibi SPECT images as well as to evaluate the effect of extracardiac activity on AC SPECT images with 99mTc and 201Tl. METHODS AND RESULTS: A phantom measurement and a study of 21 patients with low likelihood of coronary artery disease were performed with a triple-head SPECT system equipped with a americium 241 line source. In the phantom study, the presence of extracardiac activity increased the inferior-to-anterior ratios, particularly with 201Tl (1.01 to 1.32). In the clinical data, reduced count density with 201Tl compared to 99mTc-sestamibi was observed in most of the noninferior segments. On an individual segment basis, 37 (20%) of 189 segments from 11 (52%) of 21 subjects showed reduced count density on the 201Tl image compared to 99mTc-sestamibi by >10% of peak activity. CONCLUSIONS: There is a significant difference in myocardial count density distribution between 99mTc-sestamibi and 201Tl on AC SPECT images, indicating that a careful image interpretation that considers the different normal count density distribution between the tracers and/or a tracer specific normal database is necessary, especially when defect reversibility is of concern. Further work should aim for the incorporation of scatter correction combined with attenuation correction.

Aged↗