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Technetium-99m Pyrophosphate Scintigraphic Finding in Cardiac Amyloidosis: A Case Report

心臟類澱粉沈積症在鎝-99m-焦磷酸鹽閃爍造影的表現:個案報告

摘要


類澱粉沈積症是一種系統性疾病,由不可溶的微纖維在細胞外堆積造成。在可受影響的器官當中,心臟的侵犯是促成死亡的主因。心臟超音波及鎝-99m-焦磷酸鹽閃爍造影常用來評估心臟的類澱粉沈積症。在這個案例中,我們報告一例65歲男性,有鬱血性心臟衰竭的症狀與表徵。由家族病史懷疑心臟類澱粉沈積症。心臟超音波顯示心室肥厚且心室的心肌內有閃亮顆粒狀。鎝-99m-焦磷酸鹽的閃爍造影顯示兩側心室的心肌有廣泛高強度的鎝-99m-焦磷酸鹽攝取。之後由胸壁皮下脂肪切片證實了這個診斷。

並列摘要


Amyloidosis is a rare systemic disorder caused by extracellular deposition of insoluble fibrils in a wide spectrum of tissues and organs. Among the variety of affected organs, cardiac involvement contributes to the majority of death. Echocardiography and technetium-99m pyrophosphate ((superscript 99m)Tc-PYP) scintigraphy are the common non-invasive imaging modalities in the evaluation of cardiac amyloidosis. In this case report, we present a 65-year-old man with symptoms and signs of congestive heart failure. Cardiac amyloidosis was suspected from his family history. Echocardiography revealed diffuse myocardial hypertrophy and hyperechoic granular sparkling texture in the myocardium. (superscript 99m)Tc-PYP scintigraphy showed diffuse and intense (superscript 99m)Tc-PYP uptake in bilateral ventricular myocardium. The pathological result from a biopsy of subcutaneous fat from the chest wall later confirmed the diagnosis.

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