Right ventricular 18F-FDG uptake is an important indicator for cardiac involvement in patients with suspected cardiac sarcoidosis
Right ventricular 18F-FDG uptake is an important indicator for cardiac involvement in patients with suspected cardiac sarcoidosis
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DOI：
10.1007/s12149-014-0860-7
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发表时间：
2014-08-01
影响因子：
2.6
通讯作者：
Tamaki, Nagara
中科院分区：
文献类型：
--
作者：
Manabe, Osamu;Yoshinaga, Keiichiro;Tamaki, Nagara
心脏结节病最常见于左心室(LV)游离壁。右室(RV)的存在并不常见，但可能有助于发现结节病的心脏受累。F-18-氟代脱氧葡萄糖(F-18-FDG)PET已用于检测心脏结节病左室部位。然而，对房车的参与并没有做到这一点。本研究的目的是评估右室F-18-FDG摄取及其与左室壁F-18-FDG阳性节段分布的关系，并评估右室F-18-FDG摄取阳性的患者是否符合日本厚生福利省(JMHW)1993年关于疑似心脏受累的结节病的诊断标准。59例经活检证实的心外结节病患者(年龄56.1+/-A 14.7岁)因心电图或超声心动图异常而怀疑心脏受累，行空腹F-18-FDG PET或PET/CT检查。59例患者中，35例(59.3%)显示右室和/或左室壁F-18-FDG摄取异常。右室壁13例(22.0%)F-18-FDG摄取异常。右室F-18-FDG摄取组受累节段数为4.8+/-A2.4，明显高于无摄取组的1.8+/-A2.2(P<；0.0001)。有右室摄取的患者(n=27)比无右室摄取的患者(84.6%比34.8%，P=0.0033)更符合JMHW指南的诊断标准。在本研究人群中，F-18FDGPET发现右室受累的频率低于左室受累。然而，RV摄取的患者表现出更多的LV相关节段，并更频繁地符合JMHW的诊断标准。虽然RV摄取的频率较低，但F-18-FDG RV摄取可能有助于诊断结节病的心脏受累。
Cardiac sarcoidosis is most commonly found in the left ventricular (LV) free wall. Presence in the right ventricle (RV) is less common but might be useful for detecting cardiac involvement of sarcoidosis. F-18-fluorodeoxyglucose (F-18-FDG) PET has been used to detect LV regions with cardiac sarcoidosis. However, the same has not been done for RV involvement. The aims of the current study were to evaluate RV F-18-FDG uptake and its relationship to the distribution of LV wall F-18-FDG-positive segments in the LV, and to evaluate whether patients with positive RV F-18-FDG uptake met the 1993 diagnostic criteria of the Japanese Ministry of Health and Welfare (JMHW) guidelines regarding sarcoidosis with suspected cardiac involvement.Fifty-nine biopsy-proven extra-cardiac sarcoidosis patients (age 56.1 +/- A 14.7 years) with suspected cardiac involvement based on abnormal electrocardiography or echocardiography findings underwent fasting F-18-FDG PET or PET/CT. The LV wall was divided into 17 segments and RV uptake was also evaluated.Among 59 patients, 35 (59.3 %) showed some abnormal F-18-FDG uptake in the RV and/or LV wall. With respect to the RV wall, 13 (22.0 %) showed abnormal F-18-FDG uptake. The number of LV-involved segments was 4.8 +/- A 2.4 in the patients with RV F-18-FDG uptake, which was significantly higher than in the patients without RV uptake, 1.8 +/- A 2.2 (P < 0.0001). Patients with RV uptake more frequently met the diagnostic criteria of the 1993 JMHW guidelines (n = 27), than did those without RV uptake (84.6 vs. 34.8 %, P = 0.0033).F-18-FDG PET identified RV involvement less frequently than LV involvement in this study population. However, patients who had RV uptake showed a greater number of LV-involved segments and met the JMHW diagnostic criteria more frequently. Although RV uptake is less frequent, F-18-FDG RV uptake may be useful in diagnosing cardiac involvement in sarcoidosis.UMIN000006533.