Comparison of (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) in corticosteroid-naive patients with conduction system disease due to cardiac sarcoidosis.
Comparison of (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) in corticosteroid-naive patients with conduction system disease due to cardiac sarcoidosis.
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(18)F-氟脱氧葡萄糖正电子发射断层扫描 (FDG PET) 和心脏磁共振 (CMR) 在未使用皮质类固醇且因心脏结节病导致传导系统疾病的患者中进行比较。
DOI：
10.1007/s00259-015-3181-8
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Beanlands
中科院分区：
文献类型：
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作者：
Ohira H;Birnie DH;Pena E;Bernick J;Mc Ardle B;Leung E;Wells GA;Yoshinaga K;Tsujino I;Sato T;Manabe O;Oyama-Manabe N;Nishimura M;Tamaki N;Dick A;Dennie C;Klein R;Renaud J;deKemp RA;Ruddy TD;Chow BJ;Davies R;Hessian R;Liu P;Beanlands
目的心脏结节病（CS）是引起传导系统疾病（CSD）的一种疾病，18F-脱氧葡萄糖正电子发射断层显像（FDG PET）和心脏磁共振（CMR）是诊断CS的常用方法。这些的相对诊断价值尚未得到很好的研究。其目的是比较这些成像方式在此population.MethodsWe招募激素初治患者新诊断的CSD由于CS。所有CS患者均在12周内接受了两项成像研究。方法：将30例患者分为两组：A组为慢性轻度CSD（右束分支传导阻滞和/或电轴偏移），B组为新发房室传导阻滞（AVB，Mobitz Ⅱ型或Ⅲ度AVB）。A组72%的患者（13/18）和B组58%的患者（7/12）在两项影像学检查中均观察到阳性结果。A组其余患者（28%）仅CMR阳性。在B组中，仅CMR阳性的患者占8%，仅FDG PET阳性的患者占33%。A组患者仅CMR阳性的可能性更大，而B组患者仅FDG PET阳性的可能性更大（p= 0.02）。B组患者仅FDG PET阳性进行CMR早于其病理学比患者阳性仅CMR（中位数7.0，IQR 1.5 - 34.3，与72.0，IQR 25.0 - 79.5天;p= 0.03）。这项研究表明，CMR可以充分检测与慢性轻度CSD相关的心脏受累。在新发AVB和CMR研究阴性的患者中，FDG PET可能有助于检测CS引起的心脏受累。
PurposeCardiac sarcoidosis (CS) is a cause of conduction system disease (CSD).18F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population.MethodsWe recruited steroid-naive patients with newly diagnosed CSD due to CS. All CS patients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups:group Awith chronic mild CSD (right bundle branch block and/or axis deviation), andgroup Bwith new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB).ResultsThirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p= 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 – 34.3, vs. 72.0, IQR 25.0 – 79.5 days;p= 0.03).ConclusionThe number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS.