Serial assessment of cardiac involvement in sarcoidosis by delayed 18F-fluorodeoxyglucose PET/CT
Serial assessment of cardiac involvement in sarcoidosis by delayed 18F-fluorodeoxyglucose PET/CT
复制标题
通过延迟 18F-氟脱氧葡萄糖 PET/CT 对结节病心脏受累进行系列评估
DOI：
10.1007/s12350-022-03151-w
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发表时间：
2023
影响因子：
2.4
通讯作者：
Oyama-Manabe Noriko
中科院分区：
文献类型：
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作者：
Aikawa Tadao;Manabe Osamu;Ibe Tatsuro;Oyama-Manabe Noriko
我们最近在《核心脏病学杂志》上报道了一位47岁的女性，在接受18F-脱氧葡萄糖(18F-FDG)治疗后，仅通过120分钟的延迟相正电子发射断层扫描(PET)/计算机断层扫描(CT)才发现了一例活动性心脏结节病。1患者无心脏症状，PET扫描后因左心室射血分数正常，未接受激素治疗。随访期间心电图显示窦性心律正常，无传导异常(图1)。在第一次PET扫描一年后，她接受了18F-FDG PET/CT检查，以监测疾病活动性，并进行了19小时的预测禁食和低碳水化合物饮食准备(图2)。与一年前相比，心肌18F-FDG在基础间隔壁的摄取更为显著(最大标准摄取值[SUVmax]在注射18F-FDG后60分钟和120分钟分别为4.7和10.0)(SUVmax在120分钟为1.6)。此外，仅在120分钟的延迟期PET/CT图像(120分钟的SUVmax为2.7；图2BC，箭头)时，才在基底前间隔壁发现额外的18F-FDG摄取，表明心脏结节病仍处于活动期。与注射18F-FDG后60分钟的血池活动(SUV平均值为1.2)相比，延迟相图上的血池活动较低(SUV平均值为0.61)。随后，她被安排接受心脏结节病的类固醇治疗。根据2018年日本核心脏病学会关于18F-FDG显像诊断心脏结节病的建议，建议PET扫描的时间是在18F-FDG注射后60至90分钟。2然而，在我们的病例中，延迟的18F-FDG PET图像与传统的定时图像相比，显示出更高的诊断率。鉴于最近的一项荟萃分析表明，18F-FDG PET显像在检测心脏结节病方面不如心脏磁共振成像灵敏，需要进一步研究3项研究，以探讨18F-FDG PET对疑似心脏结节病患者的最佳采集时机。
We recently reported on a 47-year-old woman with active cardiac sarcoidosis detected only by 120-minute delayed phase positron emission tomography (PET)/computed tomography (CT) images after 18F-fluorodeoxyglucose administration (18F-FDG) in Journal of Nuclear Cardiology. 1 She had no cardiac symptoms and did not receive steroid treatment after the PET scan because her left ventricular ejection fraction was normal. Electrocardiography demonstrated normal sinus rhythm with no conduction abnormalities during the follow-up period (Fig. 1). One year after the initial PET scan, she underwent 18F-FDG PET/CT for monitoring the disease activity, with 19-hour pretest fasting and low-carbohydrate diet preparation (Fig. 2). Myocardial 18F-FDG uptake in the basal inferoseptal wall was more prominent (maximum standardized uptake value [SUVmax] of 4.7 at 60 minutes and 10.0 at 120 minutes after 18F-FDG administration) compared to one year ago (SUVmax of 1.6 at 120 minutes, Fig. 2 A). Furthermore, an additional 18F-FDG uptake was found in the basal anteroseptal wall only at the 120-minute delayed phase PET/CT images (SUVmax of 2.7 at 120minutes; Fig. 2 BC, arrows), indicating cardiac sarcoidosis still in active phase. Blood pool activity was lower at the delayed phase images (SUVmean of 0.61) compared to those at 60 minutes (SUVmean of 1.2) after 18F-FDG administration. She was subsequently scheduled to receive steroid treatment for cardiac sarcoidosis. According to the 2018 Japanese Society of Nuclear Cardiology recommendations for 18F-FDG imaging for diagnosis of cardiac sarcoidosis, the recommended timing of PET scan is 60 to 90 minutes after 18F-FDG administration. 2 However, delayed 18F-FDG PET images in our case showed an improved diagnostic yield compared to the conventional timing image. Given that a recent meta-analysis has suggested that 18F-FDG PET imaging is less sensitive than cardiac magnetic resonance imaging in detecting cardiac sarcoidosis, 3 further studies are needed to investigate the optimal acquisition timing of 18F-FDG PET for patients with suspected cardiac sarcoidosis.