Efficacy of Iodine-123-15-(p-iodophenyl)-3-R, S-Methylpentadecanoic Acid Single Photon Emission Computed Tomography Imaging in Detecting Myocardial Ischemia in Children With Kawasaki Disease
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概要
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To evaluate its efficacy in detecting myocardial ischemia in children, iodine-123-labeled 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP) myocardial single photon emission computed tomography (SPECT) imaging was performed in 16 pediatric patients with Kawasaki disease (KD, 11 male, 5 female; mean age and range: 13 years 8 months and 8 years 11 months to 17 years 7 months). Five children with chest pain and no cardiac disease were studied as controls (2 male, 3 female; mean age and range: 13 years 4 months and 9 years 4 months to 17 years 11 months). Selective coronary angiography was also performed in the 16 patients to evaluate the location of coronary stenosis and coronary aneurysms. The SPECT images were expressed as polar maps (Bull's eye maps) and the 'defect' area was defined as where the uptake of BMIPP was less than the standardized BMIPP images of the 5 control children. In the 16 patients, 33 segments had coronary aneurysms and 10 (10/33: 30.3%) had significant coronary stenosis on selective coronary angiography. Nine of the 10 (90%) segments with significant coronary stenosis showed a defect on the BMIPP image whereas only 6 of the 23 (26.1%) segments without coronary stenosis showed a defect on BMIPP imaging. The sensitivity of BMIPP SPECT imaging for detection of coronary stenosis was 90% (9/10) and its specificity was 73.9% (17/23), whereas the sensitivity of ^<201>T1 SPECT imaging was 80% (8/10) and its specificity was 60% (14/23). There was no significant difference between the BMIPP and ^<201>T1 SPECT images in either the sensitivity or specificity for the detection of coronary stenosis. In the present series, only one case had discordant BMIPP uptake (BMIPP uptake<^<201>Tl uptake) in which there was a large coronary aneurysm and re-canalization after complete obstruction at segment 1 of the right coronary artery. This discordant BMIPP uptake reflects the possibility of ischemic but viable myocardium after re-canalization of a large aneurysm in KD. In conclusion, BMIPP SPECT imaging is useful for detecting the areas of ischemic myocardium caused by coronary artery stenosis in children with KD.
- 社団法人日本循環器学会の論文
- 2003-07-20
著者
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KIKUCHI Yutaka
Department of Pediatrics, Jichi Medical School
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SHIRAISHI Hirohiko
Department of Pediatrics, Jichi Medical School
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MOMOI Mariko
Department of Pediatrics, Jichi Medical School
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Hoshina Masaru
Department of Pediatrics, Jichi Medical School
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Kikuchi Yutaka
Department Of Cardiology Kyushu Kosei-nenkin Hospital
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Kikuchi Yutaka
Department Of Pediatrics Jichi Medical University School Of Medicine
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IGARASHI Hiroshi
Department of Urology, Nihon University School of Medicine
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Momoi Mariko
Department Of Pediatrics Jichi Medical University School Of Medicine
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Momoi Mariko
Department Of Paediatrics Jichi Medical School
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Hoshina Masaru
Department Of Pediatrics Jichi Medical University
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Hoshina Masaru
Department Of Pediatrics Jichi Medical School
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ICHIHASHI Kou
Department of Pediatrics, Jichi Medical University
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Ichihashi Kou
Department Of Pediatrics Jichi Medical University School Of Medicine
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Ichihashi Kou
Department Of Pediatric Cardiology German Heart Institute Berlin
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Shiraishi Hirohiko
Department Of Pediatrics Jichi Medical University School Of Medicine
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Shiraishi Hirohiko
Department Of Pediatrics
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Igarashi Hiroshi
Department Of Electronical And Electronic Engineering Tokyo Denki University
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Igarashi Hiroshi
Department Of Pediatrics Jichi Medical School
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Momoi Mariko
Department of Pediatrics, Jichi Medical University School of Medicine
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