Symmetrical lesions in the temporal poles and external capsules on brain MRI are known as radiological markers of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL); however, similar imaging findings have also been reported in neuromyelitis optica spectrum disorder (NMOSD), and this study investigated the frequency of such findings. The study included 55 NMOSD patients who met the 2015 international NMO diagnosis panel (IPND) criteria and were positive for aquaporin-4 antibodies (AQP4-Ab). Images were evaluated based on the consensus of two neuroradiologists, and brain lesions were detected in 33 patients, of whom 2 (6%) had symmetrical lesions in both the temporal poles and external capsules, and 1 (3%) had symmetrical lesions confined to the external capsules. Therefore, when symmetrical lesions in the temporal poles and external capsules are observed on MRI, NMOSD should be considered in the differential diagnosis.

PURPOSE: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are two major demyelinating diseases affecting the central nervous system (CNS). The objective of this study is to evaluate the prevalence of pontine trigeminal nerve lesions in patients diagnosed with MS and NMOSD using MRI. METHODS: This retrospective study included patients diagnosed with MS or NMOSD between July 2018 and July 2023. MS patients were clinically diagnosed using the 2017 McDonald criteria, while NMOSD patients were those who met the 2015 International Panel for NMO Diagnosis (IPND) criteria and were positive for Aquaporin-4 Antibody (AQP4-Ab). RESULTS: The study included a total of 90 patients, with 45 diagnosed with MS and another 45 with NMOSD. Pontine trigeminal nerve lesions were observed in both MS and NMOSD, but were more prevalent in MS patients (20 % vs. 2 %, p = 0.008). Root entry zone (REZ) lesions were found in 4 of 45 MS patients, accounting for 9 % (95 % CI: 3 %-17 %), and were absent in the NMOSD group; however, there was no significant difference between the two groups (p = 0.12). Of the MS patients with pontine trigeminal nerve lesions, 6 out of 9 (63 %; 95 % CI, 36 %-98 %) exhibited bilateral lesions, which was significantly more prevalent compared to the NMOSD group (13 % vs. 0 %, p = 0.03). CONCLUSIONS: The presence of pontine trigeminal nerve lesions, particularly when bilateral, are significantly more prevalent in MS patients than in those with NMOSD, suggesting their utility as a distinctive marker and potential diagnostic indicator specifically for MS.

Solitary fibrous tumor (SFT) is a rare interstitial tumor that originates from various soft tissues, and SFTs occurring within the cranium are extremely rare. While intracranial SFTs with cerebral hemorrhage or subarachnoid hemorrhage have been reported, there have been no reports of intracranial SFTs causing subdural hematoma. In this case, we report on an intracranial SFT accompanied by a subdural hematoma. A 29-year-old female was emergently transported due to the sudden onset of persistent headache and vomiting that began the night before. CT and MRI imaging revealed a hemorrhagic tumor under the tentorium and an acute subdural hematoma extending along the tentorium. The excised tumor was diagnosed as an SFT through histopathological examination. After undergoing radiation therapy, no recurrence has been observed. This is the first case report of an SFT accompanied by a subdural hematoma, and it is vital to recognize that SFTs can be associated with subdural hematomas for proper diagnosis and treatment planning.

BACKGROUND AND AIM: A multicenter, open-label randomized Phase II trial was conducted to determine whether low-dose gemcitabine plus nab-paclitaxel (GnP) could improve tolerability and show equivalent efficacy to the standard-dose GnP for elderly patients with metastatic pancreatic cancer. METHODS: Consecutive patients aged ≥65 years with metastatic pancreatic cancer who presented at one of four Japanese referral centers between November 2016 and January 2021 were enrolled. The 60 patients were randomly assigned to low- or standard-dose groups with a 1:1 ratio. Patients in the low-dose GnP group received gemcitabine at a dose of 250 mg/m2 and nab-paclitaxel at 125 mg/m2. RESULTS: Low-dose GnP significantly decreased the rate of cases requiring dose reduction (16.7% vs 63.3%). The response rate (36.7% vs 33.3%) and progression-free survival (7.3 vs 8 months) were comparable between the low- and standard-dose groups as determined by independent review. The difference in the median overall survival between the two groups was not significant (7.9 vs 12 months). The proportion of patients with hematologic and non-hematologic treatment-related adverse events was comparable between the two groups. CONCLUSION: Low-dose GnP had an equivalent efficacy to conventional therapy; however, it did not reduce adverse events.

We aimed to examine the accuracy of tumor staging of intrahepatic cholangiocarcinoma (ICC) by using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET-CT). From January 2001 to December 2021, 202 patients underwent PET-CT, CT, and MRI for the initial staging of ICC in two institutions. Among them, 102 patients had undergone surgical treatment. Ninety patients who had a histopathological diagnosis of ICC were retrospectively reviewed. The sensitivity and specificity of 18F-FDG PET-CT, CT, and magnetic resonance imaging (MRI) in detecting tumors, satellite focus, vascular invasion, and lymph node metastases were analyzed. Ninety patients with histologically diagnosed ICC were included. PET-CT demonstrated no statistically significant advantage over CT and MR in the diagnosis of multiple tumors and macrovascular invasion, and bile duct invasion. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT in lymph node metastases were 84%, 86%, 91%, 84%, and 86%, respectively. PET-CT revealed a significantly higher accuracy compared to CT or MRI (86%, 67%, and 76%, p < 0.01, respectively) in the diagnosis of regional lymph node metastases. The accuracy of tumor staging by PET-CT was higher than that by CT/MRI (PET-CT vs. CT vs. MRI: 68/90 vs. 47/90 vs. 51/90, p < 0.05). 18F-FDG PET-CT had sensitivity and specificity values for diagnosing satellite focus and vascular and bile duct invasion similar to those of CT or MRI; however, PET-CT showed higher accuracy in diagnosing regional lymph node metastases. 18F-FDG PET-CT exhibited higher tumor staging accuracy than that of CT/MRI. Thus, 18FDG PET-CT may support tumor staging in ICC.

Objective: We evaluated the relationship between regional accumulations of the tau positron emission tomography (PET) tracer THK5351 and cognitive dysfunction in the Alzheimer's disease (AD) continuum. Methods: The cases of 18 patients with AD or mild cognitive impairment (MCI) due to AD who underwent three-dimensional MRI, fluoro-2-deoxyglucose (FDG)-(PET), Pittsburgh compound B (PiB)-amyloid PET, and THK5351-tau PET were analyzed. Their mean age was 70.6 ± 11.3, their mean Mini-Mental State Examination (MMSE) score was 22.3 ± 6.8, and their mean Alzheimer Disease Assessment Scale-Cognitive Subtest (ADAS) score was 12.5 ± 7.3. To determine the correlation between each patient's four imaging results and their MMSE and ADAS scores, we performed a voxel-wise statistical analysis with statistical parametric mapping (SPM). Results: The SPM analysis showed that the bilateral parietotemporal FDG accumulations and MMSE scores were positively correlated, and the bilateral parietotemporal FDG accumulations were negatively correlated with ADAS scores. There were significant correlations between bilateral parietotemporal and left posterior cingulate/precuneus THK5351 accumulations and MMSE/ADAS scores. Conclusion: In the AD brain, THK5351 correlates with neuropsychological test scores as well as or more additional than FDG due to its affinity for both tau and monoamine oxidase-B (MAO-B), and measurements of THK5351 may thus be useful in estimating the progression of AD.

＜文献概要＞肝膵脾領域の間膜や靱帯は,主としてそれぞれの臓器を支持する役割を有する一方,炎症や腫瘍の進展経路となり,日常臨床で,それらを詳細に画像診断することは重要である.間膜や靱帯自体は,通常CTでは同定困難な場合が多いが,ランドマークとなる血管などによって把握することができ,また腹水貯留,炎症波及や腫瘍浸潤によって顕在化し,指摘することができる.膜,靱帯の病変の広がりに対する画像診断は単に所見を拾い上げるだけでなく,正確な局在診断やいかに膜,靱帯,間隙に病変が及んだのかなどの病態把握に必要で,そのためにはこれらの複雑な走行,広がりを,主に2次元表示であるCT画像から頭の中で3次元構築することが求められる.本稿では,肝膵脾に関与する間膜・靱帯の解剖と画像を解説し,臨床上注目すべき点についても述べる.

To evaluate the feasibility and safety of the Amplatzer vascular plug (AVP) for preoperative common hepatic embolization (CHA) before distal pancreatectomy with en bloc celiac axis resection (DP-CAR) to redistribute blood flow to the stomach and liver via the superior mesenteric artery (SMA). Four patients (3 males, 1 female; median age 69 years) with locally advanced pancreatic body cancer underwent preoperative CHA embolization with AVP. After embolization, SMA arteriography was performed to confirm the alteration of blood flow from the SMA to the proper hepatic artery. In three of four patients, technical successes were achieved with sufficient margin from the origin of gastroduodenal artery. In one patient, the margin was less than 5 mm, although surgery was successfully performed without any problem. Eventually, all patients underwent the DP-CAR without arterial reconstruction or liver ischemia. AVP application is feasible and safe as an embolic procedure for preoperative CHA embolization of DP-CAR.

The purpose of this study was to investigate the usefulness of T1W black-blood Cube (BB Cube) and T1W BB Cube fluid-attenuated inversion recovery (BB Cube-FLAIR) sequences for contrast-enhanced brain imaging, by evaluating flow-related artefacts, detectability, and contrast ratio (CR) of intracranial lesions among these sequences and T1W-SE. Phantom studies were performed to determine the optimal parameters of BB Cube and BB Cube-FLAIR. A clinical study in 23 patients with intracranial lesions was performed to evaluate the usefulness of these two sequences for the diagnosis of intracranial lesions compared with the conventional 2D T1W-SE sequence. The phantom study revealed that the optimal parameters for contrast-enhanced T1W imaging were TR/TE = 500 ms/minimum in BB Cube and TR/TE/TI = 600 ms/minimum/300 ms in BB Cube-FLAIR imaging. In the clinical study, the degree of flow-related artefacts was significantly lower in BB Cube and BB Cube-FLAIR than in T1W-SE. Regarding tumour detection, BB Cube showed the best detectability; however, there were no significant differences in CR among the sequences. At 1.5 T, contrast-enhanced BB Cube was a better imaging sequence for detecting brain lesions than T1W-SE or BB Cube-FLAIR. aEuro cent Cube is a single-slab 3D FSE imaging sequence. aEuro cent We applied a black-blood (BB) imaging technique to T1W Cube. aEuro cent At 1.5 T, contrast-enhanced T1W BB Cube was valuable for detecting brain lesions.

Background: The purpose of this study was to quantitatively evaluate the tumor accumulation and heterogeneity of In-111-ibritumomab tiuxetan (Zevalin (R)) and tumor accumulation of F-18-fluoro-deoxyglucose (FDG) and compare them to the tumor response in B-cell non-Hodgkin's lymphoma patients receiving Y-90-ibritumomab tiuxetan (Zevalin (R)) therapy. Methods: Sixteen patients with histologically confirmed non-Hodgkin's B-cell lymphoma who underwent Y-90-ibritumomab tiuxetan therapy along with In-111-ibritumomab tiuxetan single-photon emission computerized tomography (SPECT)/CT and FDG positron emission tomography (PET)/CT were enrolled in this retrospective study. On pretherapeutic FDG PET/CT images, the maximum standardized uptake value (SUVmax) was measured. On SPECT/CT images, a percentage of the injected dose per gram (%ID/g) and SUVmax of In-111-ibritumomab tiuxetan were measured at 48 h after its administration. The skewness and kurtosis of the voxel distribution were calculated to evaluate the intratumoral heterogeneity of tumor accumulation. As another intratumoral heterogeneity index, cumulative SUV-volume histograms describing the percentage of the total tumor volume above the percentage thresholds of pretherapeutic FDG and In-111-ibritumomab tiuxetan SUVmax (area under the curve of the cumulative SUV histograms (AUC-CSH)) were calculated. All lesions (n = 42) were classified into responders and non-responders lesion-by-lesion on pre- and post-therapeutic CT images. Results: A positive correlation was observed between the FDG SUVmax and accumulation of In-111-ibritumomab tiuxetan in lesions. A significant difference in pretherapeutic FDG SUVmax was observed between responders and non-responders, while no significant difference in In-111-ibritumomab tiuxetan SUVmax was observed between the two groups. In contrast, voxel distribution of FDG demonstrated no significant differences in the three heterogeneity indices between responders and non-responders, while In-111-ibritumomab tiuxetan demonstrated skewness of 0.58 +/- 0.16 and 0.73 +/- 0.24 (p < 0.05), kurtosis of 2.39 +/- 0.32 and 2.78 +/- 0.53 (p < 0.02), and AUC-CSH of 0.37 +/- 0.04 and 0.34 +/- 0.05 (p < 0.05) for responders and non-responders. Conclusions: Pretherapeutic FDG accumulation was predictive of the tumor response in Y-90-ibritumomab tiuxetan therapy. The heterogeneity of the intratumoral distribution rather than the absolute level of In-111-ibritumomab tiuxetan was correlated with the tumor response.

短寿命かつ多重α・β崩壊を系列で行う²²³Ra薬剤の骨腫瘍疼痛治療への適用が日本でも開始されようとしているが，²²³Ra薬剤の管理に関わる知見はほとんど蓄積されていない。<br>本調査では²²³Ra薬剤による飛沫汚染の管理に関する実験を行った。実験の結果，広口GMサーベイメータは汚染の管理に非常に有効に機能するのに対して，NaI(Tl)シンチレーションサーベイメータは検出限界を考慮する必要があるとの結論を得た。

Objective The objective of our study was to evaluate diagnostic ability and features of quantitative indices of three modalities: uptake rate on norcholesterol scintigraphy, computed tomography (CT) attenuation value, and fat suppression on chemical-shift magnetic resonance imaging (MRI) for characterizing adrenal adenomas. Methods Image findings of norcholesterol scintigraphy, CT, and MRI were reviewed for 78 patients with functioning (n = 48) or nonfunctioning (n = 30) adrenal masses. The norcholesterol uptake rate, attenuation value on unenhanced CT, and suppression on in-phase to opposed-phase MRI were measured for adrenal masses. Results The norcholesterol uptake rate, CT attenuation value, and MR suppression index showed the sensitivity of 60%, 82%, and 100%, respectively, for functioning adenomas of < 2.0 cm, and 96%, 79%, and 67%, respectively, for those of >= 2.0 cm. A statistically significant correlation was observed between size and norcholesterol uptake, and between CT attenuation value and MR suppression index. Regarding norcholesterol uptake, the adenoma-to-contralateral gland ratio was significantly higher in cortisol releasing than in aldosterone-releasing adenomas. Conclusions The norcholesterol uptake rate was reliable for characterization of adenomas among adrenal masses of >= 2.0 cm. CT attenuation value and MR suppression index were well correlated with each other, and were useful regardless of mass size.

ファントム実験で得られた回復係数(RCs)を用い、部分容積効果の影響を受けやすいリンパ節のStandardized uptake values(SUV)補正を行うことで、肺癌および食道癌での縦隔リンパ節転移の診断能が向上するか検討した。肺癌においても食道癌においても、リンパ節転移の診断には、ROC解析でsizeよりもSUVmaxとcSUVmaxでの評価の方が大きなAzを示し、高い診断能を有した。SUVmaxとcSUVmaxの比較では、補正によりAzがやや低下し、小病変の低いSUVmaxが過大に補正されて診断能を損なった可能性があった。食道癌の転移陽性リンパ節は肺癌の転移陽性リンパ節に比してsizeが小さく、SUVmaxが低い傾向があり、腫瘍ごとにリンパ節転移のsize、SUVmaxについて指標を設定する必要が考えられた。

Purpose. Motion artifact is problematic in the diagnosis of Creutzfeldt-Jakob disease (CJD) because of dementia. The purpose was to compare the occurrence of this artifact between a diffusion-weighted (DW) magnetic resonance ( MR) imaging sequence and conventional sequences. Materials and methods. Ten MR examinations comprising T2- weighted, T1- weighted, DW, and fl uidattenuated inversion recovery imaging in seven CJD patients were retrospectively evaluated. The occurrence of motion artifacts on each sequence were assessed, and the examination was classifi ed into four groups as follows: group A, motion artifact not revealed on DW imaging but revealed on one or more other sequences; group B, revealed on DW imaging and one or more other sequences; group C, not revealed on any sequences; and group D, revealed on DW imaging but not on any other sequences. Results. The 10 MR examinations were classifi ed as eight group A ( 80%), one B ( 10%), one C ( 10%), and zero D ( 0%). Conclusion. Motion artifacts are likely to occur in any conventional imaging sequences in CJD, but the fastimaging ability of DW imaging can reduce this artifact. The combination of an absence of motion artifact on DW imaging and the presence on conventional sequences may be one of the frequent fi ndings of CJD.

Purpose. Motion artifact is problematic in the diagnosis of Creutzfeldt-Jakob disease (CJD) because of dementia. The purpose was to compare the occurrence of this artifact between a diffusion-weighted (DW) magnetic resonance (MR) imaging sequence and conventional sequences. Materials and methods. Ten MR examinations comprising T2-weighted, T1-weighted, DW, and fluid-attenuated inversion recovery imaging in seven CJD patients were retrospectively evaluated. The occurrence of motion artifacts on each sequence were assessed, and the examination was classified into four groups as follows: group A, motion artifact not revealed on DW imaging but revealed on one or more other sequences group B, revealed on DW imaging and one or more other sequences group C, not revealed on any sequences and group D, revealed on DW imaging but not on any other sequences. Results. The 10 MR examinations were classified as eight group A (80%), one B (10%), one C (10%), and zero D (0%). Conclusion. Motion artifacts are likely to occur in any conventional imaging sequences in CJD, but the fast-imaging ability of DW imaging can reduce this artifact. The combination of an absence of motion artifact on DW imaging and the presence on conventional sequences may be one of the frequent findings of CJD. © 2008 Japan Radiological Society.

PURPOSE: To prospectively evaluate aortic and hepatic enhancement and depiction of hypervascular hepatocellular carcinoma (HCC) between two contrast materials with moderate and high iodine concentrations when administered at same iodine dose and injection duration at multi - detector row helical computed tomography (CT). MATERIALS AND METHODS: Institutional review board approval and informed patient consent were obtained. One hundred eighty-six patients were studied, and 67 patients with hypervascular HCC were identified. Ninety-four patients were assigned to receive iohexol 350 (mg iodine per milliliter) with protocol A; 92, iohexol 300 with protocol B. In both protocols, iohexol with same iodine load per weight ( 518 mg/kg) was administered with same injection duration ( 25 seconds). Multiphase CT scanning was started 10, 20, 50, and 180 seconds after the trigger ( threshold level set at increase of 100 HU over baseline CT number of aorta). Enhancement of aorta and liver was measured in 186 patients. Tumor-to-liver contrast was measured in 67 patients with hypervascular HCC. Statistical analysis was performed with Mann-Whitney U test. RESULTS: Medians of aortic enhancement during four phases were 325, 185, 112, and 69 HU with protocol A. Corresponding values were 344, 266, 121, and 73 HU with protocol B. During all phases, aortic enhancement was significantly higher with protocol B ( P =.046, P <.001, P <.001, and P =.002). Hepatic enhancement during four phases was 6, 21, 48, and 34 HU with protocol A. Corresponding values were 3, 17, 47, and 35 HU with protocol B. Hepatic enhancement was significantly higher with protocol A during first and second phases ( P <.001 for both), although there was no significant difference between protocols during third and fourth phases ( P =.778 and P =.178, respectively). Medians of tumor-to-liver contrast during four phases were 22, 34, 0.5, and - 1.1 HU with protocol A. Corresponding values were 23, 45, 0, and - 8.6 HU with protocol B. Tumor-to-liver contrast was significantly higher with protocol B during second phase ( P =.049), although there was no difference between protocols during other phases. CONCLUSION: When total iodine dose was adjusted to body weight and injection duration was fixed, rapid administration of moderate concentration of contrast material was more effective for depiction of hypervascular HCC than was high concentration of contrast material.

症例は73歳男性で、主訴は下痢。大動脈解離(DebakeyI型)術後1週間より発症。CTで解離の及んでいた下腸間膜動脈の閉塞を認め、虚血性腸炎と考えた。解離術後に発生する腸管虚血は稀な合併症で、上腸間膜動脈閉塞が原因となることが多く、下腸間膜動脈が原因となることは極めて稀（本邦１９８５～０３年の間で３例）である。虚血性腸炎発症時期は術後数週からという報告が多い。本症例でも術後1週間から発症しており、虚血性腸炎は解離術後から発症までにはタイムラグがあることを知っておくことは重要である。

腹部CTにて左腎腫瘍を指摘されて当院泌尿器科受診。腹部CTでは均一で骨格筋と同程度のCT値であり、内部に小さな石灰化がみられた。脂肪成分は指摘できず。造影CT早期相では均一によく造影されて、後期相では周囲の腎よりも低吸収であったがtime density curve 上は漸増性を示していた。MRI T2強調画像では骨格筋と同程度の低信号であり、chemical shift imageでは微少脂肪成分は指摘できず、in phase, opposed phaseとも腫瘤は腎実質よりも高信号を示していた。Dynamic studyではCT同様均一に造影されている。T2強調画像で腫瘍そのものが低信号を示しており、被膜の同定は不可能であった。脂肪成分が少ない血管筋脂肪腫との鑑別に苦慮したが、clear cell carcinoma以外の悪性腫瘍の可能性も考え、左腎摘出術を施行。Gerota筋膜表面の血管は強く怒張し、易出血性であった。左腎上極の癒着も著しかった。割面は灰白色で均一であった。組織診断はgranurlar cell carcinomaであった。

造影ＣＴにおけるショック、過敏症はアナフィラキシー様反応と認識され、治療、予防のためエピネフリン（商品名：ボスミン）投与が必須となっている。 副作用発現時のボスミン投与時期の明確な報告はなく、中等症以上の症例では症状発現後遅くとも１分以内の投与が推奨されている。また、気道確保等の救命措置が遅れがちなＣＴ室ではより早期段階での投与が望まれる。 以上の観点から、ボスミンの投与開始時点を検討した結果、副作用軽症例のうち、 発赤を伴った場合はアナフィラキシー様反応に特有（アナフィラキシー様症状時、８４％発現）と考え、これが認められた時点でエピネフリン筋注を開始する事とした。

造影ＣＴにおけるショック、過敏症はアナフィラキシー様反応と認識され、治療、予防のためエピネフリン（商品名：ボスミン）投与が必須となっている。 副作用発現時のボスミン投与時期の明確な報告はなく、中等症以上の症例では症状発現後遅くとも１分以内の投与が推奨されている。また、気道確保等の救命措置が遅れがちなＣＴ室ではより早期段階での投与が望まれる。 以上の観点から、ボスミンの投与開始時点を検討した結果、副作用軽症例のうち、 発赤を伴った場合はアナフィラキシー様反応に特有（アナフィラキシー様症状時、８４％発現）と考え、これが認められた時点でエピネフリン筋注を開始する事とした。

乳房温存療法にて照射中に発症した卵巣癌の症例を報告した。乳癌と卵巣癌の合併は報告されているが、実際に腫瘤増大の経過を追えたこのような症例は非常にまれである。

（目的）Tl-201心筋SPECTにおいて、QGS上の壁運動と壁厚の定量し、正常例における標準値を求めた。さらに、冠動脈造影にて冠動脈病変が確認された虚血性心疾患（IHD）患者のQGS壁運動と壁厚を求め、虚血心筋の診断における有用性について検討した。 （方法）対象は、心エコー、心電図、臨床経過によって、IHDを否定された10例を正常群（64±8歳）とした。IHD例は、冠動脈造影所見によってLAD群4例、RCA群8例、LCX群4例と群分けした。負荷・Tl-201投与直後（早期像）および3時間後（後期像）に、2検出器型ガンマカメラにより、180度収集、R-R間隔8分割により撮像した。 （結果）正常群の壁運動は、早期像と後期像の間で、心尖部、中隔、後下壁に有意差があった。正常群の壁厚は、早期像と後期像の間で、心尖部、中隔、後下壁、側壁に有意差があった。正常群とIHD群において、（後期像中隔壁運動を除く）いずれの領域にも壁運動と壁厚に有意差を認めた。また、正常群の標準値をもと

乳房温存療法中に偶然発見された非常に進行の早い卵巣癌の症例を経験したので報告した。

（目的）Tl-201心電図同期心筋SPECTにおいて、QGS上の壁運動と壁厚の定量し、正常例における標準値を求めた。さらに、冠動脈造影にて冠動脈病変が確認された虚血性心疾患（IHD）患者のQGS壁運動と壁厚を求め、虚血心筋の診断における有用性について検討した。（方法）対象は、Tl-201心筋SPECTを施行したが、心エコー、心電図、臨床経過によって、IHDを否定された10例を正常群（年齢64±8歳）とした。IHD例は、冠動脈造影所見によってLAD群4例、RCA群8例、LCX群4例と群分けした。負荷・Tl-201投与直後（早期像）および3時間後（後期像）に、2検出器型ガンマカメラにより、180度収集、R-R間隔8分割により撮像した。（結果）正常群の壁運動は、早期像と後期像の間で、心尖部（p=.0009）、中隔（p=.0018）、後下壁 （p=.0025）に有意差があった。正常群の壁厚は、早期像と後期像の間で、心尖部（p=.0001）、中隔（p=.0014）、後下壁（p=.0406）、側壁（p=.0356）に有意差があった。正常群とIHD群において、（

稀な軟部悪性腫瘍である表在型平滑筋肉腫の1例を経験したので報告する。 画像的には他の軟部腫瘍との鑑別は困難であったが、診断・治療において重要な良悪性の鑑別は、筋膜への浸潤を認めることから、悪性と判断可能であった。