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MR Vol.11 No3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.11 No.3 |
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Dipyridamole stress thallium perfusion scan for
evaluating myocardial involvement in systemic sclerosis |
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| T. Suzuki1, S. Ogasawara2, S. Ohsako-Higami1,
C. Fukasawa1, M. Hara1, N. Kamatani1 |
(1) Institute of Rheumatology, Tokyo Women's
Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054,
Japan
(2)Department of Cardiology, Aoyama Hospital, Tokyo Women's Medical University,
Tokyo, Japan |
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| Abstract |
| Abstract To evaluate the usefulness of a
dipyridamole stress thallium-201 (Tl-201) perfusion scan in detecting
myocardial
involvement in
systemic sclerosis we performed Tl-201 scans, electrocardiograms
(ECG), and echocardiograms (UCG) on 24 patients with systemic
sclerosis (11 diffuse type, 13 limited type) sequentially selected
randomly over an 8-month period, and compared the findings. Cardiac
catheterization, coronary angiography (CAG), and right ventricular
endomyocardial biopsy were performed as necessary. Of the 24
patients, Tl-201 scans revealed fixed defects (FDs; myocardial
fibrosis) and/or reversible defects (RDs; myocardial ischemia)
in nine patients, whereas ECG and UCG revealed defects in four
and three patients, respectively. Biopsy specimens obtained from
the three patients with FDs also showed both ECG and UCG abnormalities
indicative of myocardial fibrosis despite their normal appearance
with CAG. Autopsy findings on the heart of a patient who died
of acute heart failure showed myocardial fibrosis predominantly
in the left anteroposterior wall. This was consistent with the
FDs area detected using the Tl-201 perfusion scan. In a patient
with chronic heart failure, left ventriculography showed a decrease
in the anterior wall motion of the left ventricle which coincided
with the FDs area in the Tl-201 perfusion scan. In conclusion,
dipyridamole stress Tl-201 scanning is useful for evaluating
myocardial involvement in systemic sclerosis. |
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| Key words |
| Key words Dipyridamole stress thallium-201 perfusion
scan ・ Myocardial involvement ・ Systemic sclerosis |
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