松山 裕宇¹, 岩瀬 正嗣¹, 長谷川 和生¹, 武田 京子¹, 加藤 千博¹, 鯉江 伸¹, 小出 章博¹, 木村 美由紀¹, 森本 紳一郎¹, 菱田 仁¹, 梶原 克祐², 小原 健³

Hiroyuki MATSUYAMA¹, Masatsugu IWASE¹, Kazuo HASEGAWA¹, Kyoko TAKEDA¹, Chihiro KATO¹, Miyuki KIMURA¹, Shin KOIKE¹, Akihiro KOIDE¹, Shin-ichirou MORIMOTO¹, Hitoshi HISHIDA¹, Katsusuke KAJIWARA², Ken OHARA³

¹藤田保健衛生大学循環器内科, ²藤田保健衛生大学臨床検査研究部, ³藤田保健衛生大学衛生学部診療放射線技術学科

¹Department of Internal Medicine Fujita Health University, ²Joint Research Laboratory of Clinical Medicine Fujita Health University, ³Fujita Health University Faculty of Radiological Science

キーワード : Acoustic microscopy, Light microscopy, Myocardial disease, Tissue characterization

To assess the clinical usefulness of acoustic microscopy, we studied postmortem myocardial specimens from patients with various myocardial diseases. An acoustic microscopic scanning system (Hitachi) equipped with a 400 MHz transducer was used to construct two-dimensional (2D) images showing distribution of attenuation in myocardial specimens sectioned at 2 μm in thickness. For identification of tissue structures and components, consecutive serial sections were stained with hematoxyline and eosin, and Masson stain and examined by light microscopy. Regular myocardial fiber arrangement, blood cells, and interstitial tissues were discernible on acoustic microscopic examination of the myocardium of two normal human hearts. The acoustic microscopic appearance of myocardium from patients with myocardial diseases, including one patient with dilated cardiomyopathy (DCM), three with acute myocarditis, one with hypertensive hypertrophy and cardiac amyloidosis, was clearly distinguishable from that of the normal myocardium. First, the image of the interstitium of the patient with dilated cardiomyopathy contained very dark areas of increased attenuation suggestive of fibrosis, second, the myocardial fibers were irregularly arranged, broken, terminated, or appeared dark in patients with myocarditis and DCM; third, infiltration of dark, round cells, probably lymphocytes, was noted in patients with myocarditis, and fourth, the relatively dark homogenous round area, probably indicating deposition of abnormal metabolites, was seen in patients with amyloidosis. We conclude that acoustic microscopy using a 400 MHz transducer can clearly distinguish myocardial histology of myocardial disease and can thus provide detailed basic data on the acoustic properties of cells in the myocardium.