Combined gated cardiac blood pool scintigraphy and 67Ga-citrate scintigraphy for detection of cardiac lymphoproliferative disorders.
Combined gated cardiac blood pool scintigraphy and 67Ga-citrate scintigraphy for detection of cardiac lymphoproliferative disorders.
复制标题
组合门控心脏血池闪烁扫描和 67Ga 柠檬酸盐闪烁扫描，用于检测心脏淋巴增殖性疾病。
DOI：
10.1148/radiology.141.1.7291524
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发表时间：
1981
期刊：
影响因子：
19.7
通讯作者：
Strauss,HW
中科院分区：
文献类型：
--
作者：
Winzelberg,GG;Rapoport,F;Boucher,CA;Carey,RW;McKusick,KA;Strauss,HW
恶性疾病对心肌结构的浸润最常见于肺癌、乳腺癌、黑色素瘤和淋巴瘤（1，2）。约25%的非何杰金淋巴瘤患者和约10%的何杰金病患者在死后检查中表现出心脏受累。尽管淋巴瘤累及心肌在尸检中相对常见，但心脏病的临床体征和症状通常归因于非淋巴瘤相关的心脏病（1，2）。病例I证明了67 Ga-枸橼酸造影检测霍奇金病肿瘤复发的能力（3）。这个病人的心脏在放射治疗过程中被屏蔽了，要么是局部纵隔复发，要么是肿瘤病灶没有得到治疗。沿着左心缘的镓异常聚集可能代表心肌、心包或纵隔受累。多门控心血池超声心动图示心肌壁运动正常，提示无心肌损害。病例II显示门控血池扫描与镓造影同时进行，能够精确定位嗜镓肿瘤累及心脏的范围，很难将肿瘤侵犯心肌与更常见的冠状动脉疾病、瓣膜性心脏病或原发性心肌异常区分开来。通常，临床表现具有非常渐进的发作，并且这些患者也可能具有潜在的心脏异常。此外，这些患者可能正在接受对心脏有毒的化疗药物，并可能产生心血管异常。
DISCUSSIONInfiltration of myocardial structures by malignant disease is most commonly associated with lung and breast cancer, melanoma, and lymphoma(1, 2). About 25% of the patients with non-Hodgkin lymphoma and about 10% of the patients with Hodgkin disease demonstrate cardiac involvement in postmortern examination. Although myocardial involvement with lymphoma is relatively common in postmortem examination, clinical signs and symptoms of heart disease are usually attributed to nonlymphomatous related cardiac disease(1, 2). CASE I demonstrates the ability of 67Ga-citnate scintigraphy to detect tumor recurrence in Hodgkin disease(3). This patient’s heart had been shielded during the courseof radiotherapy, and either a local mediastinal recurrence developed or, less likely, a focus of tumor was left untreated. The abnormal gallium col-lection along the left heart border could have represented myocardlal, pericardial, or mediastinal involvement. The normal myocardlal wall motion seen on the multigated cardiac blood pool scintiscan suggested that it was not myocardial involve-ment. CASE II demonstrates the ability of concomitant gated blood pool scanning with gallium scintigraphy to localize pre-cisely the extent of cardiac Involvement by gallium-avid tumors.It is difficult to distinguish tumor invasion of the myocardium from the more common findings of coronary artery disease, valvulam heart disease, or primary myocamdial abnormalities. Often, the clinical presentation has a very gradual onset and these patients may also have underlying cardiac abnormalities. In addition, these patients may be receiving chemothemapeutic agents that are toxic to the heart and may produce cardlovascular abnormalities.