Summary
This study described the radiological features on echocardiography and MRI specific to cardiac amyloidosis confirmed on biopsy. Eleven cases of biopsy-proven cardiac amyloidosis were retrospectively reviewed in this study. All patients underwent biopsy, cardiac MRI and echocardiography. The main echocardiography and MRI findings were as follows: diffuse ventricular and septum wall thickening, atrial enlargement, pericardial effusion, restricted left ventricular (LV) systolic and diastolic function, characteristic granular sparkling of myocardium. MRI revealed a characteristic pattern of global subendocardial late enhancement, extending in varying degrees into the neighboring myocardium. The findings agreed with the infiltration distribution of amyloid protein. Typical abnormalities seen on echocardiography and MRI should have important diagnostic and prognostic value of cardiac amyloidosis. MRI should be considered in the diagnosis of cardiac amyloidosis if echocardiographic features are suspicious.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Meng L, Ding WH, Shi LB, et al. The clinical features and outcomes of immunoglobulin light-chain amyloidosis with heart involvement. Chin J Cardiol (Chinese), 2007,5(4): 340–343
Zeng Y, Zhu WL, Fang LG, et al. The clinical characteristics and diagnosis of heart amyloidosis. Chin J Intern Med (Chinese), 2000,39(2):91–93
vanden Driesen RI, Slaughter RE, Strugnell WE, et al. MR findings in cardiac amyloidosis. Am J Roentgenol, 2006, 186(6):1682–1685
Dubrey SW, Cha K, Anderson J, et al. The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM, 1998,91(2):141–157
Maceira AM, Joshi J, Prasad SK, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation, 2005,111(2):186–193
Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation, 2005,112(13):2047–2060
Kwong RY, Falk RH. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation, 2005,111(2):122–124
Siqueira-Filho AG, Cunha CL, Tajik AJ, et al. M-mode and two-dimensional echocardiographic features in cardiac amyloidosis. Circulation, 1981,63(1):188–196
Aerts JG, Tan KY, Veerhoek M, et al. Pleural amyloidosis as a cause of excessive pleural effusions. Ned Tijdschr Geneeskd, 1999,143(2):104–106
Chou TR, Tietjen PA. Pleural amyloidosis as a cause of pleural effusion. Chest, 2002,122(Suppl 4):S239–S240
Vogelsberg H, Mahrholdt H, Deluigi CC, et al. Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy. J Am Coll Cardiol, 2008,51(10): 1022–1030
Perugini E, Rapezzi C, Piva T, et al. Non-invasive evaluation of the myocardial substrate of cardiac amyloidosis by gadolinium cardiac magnetic resonance. Heart, 2006,92(3): 343–349
Sueyoshi E, Sakamoto I, Okimoto T, et al. Cardiac amyloidosis: typical imaging findings and diffuse myocardial damage demonstrated by delayed contrast enhanced MRI. Cardiovasc Intervent Radiol, 2006,29(4):710–712
Cheng AS, Banning AP, Mitchell AR, et al. Cardiac changes in systemic amyloidosis: visualization by magnetic resonance imaging. Int J Cardiol, 2006,113(1): 21–23
Shah KB, Inoue Y, Mehra MR. Amyloidosis and the heart: a comprehensive review. Arch Intern Med, 2006,166(17): 1805–1813
Sanchorawala V. Light-chain (AL) amyloidosis: diagnosis and treatment. Clin J Am Soc Nephrol, 2006,1(6):1331–1341
Zhang L, LV Q, Xie MX, et al. The diagnostic value of echocardiography in cardiac amloidsis. Chin J Ultrasonogr (Chinese), 2009,18(1):11–13
Rahman JE, Helou EF, Gelzer-Bell R, et al. Noninvasive diagnosis of biopsy-proven cardiac amyloidosis. J Am Coll Cardiol, 2004,43(3):410–415
Falk RH, Plehn JF, Deering T, et al. Sensitivity and specificity of the echocardiographic features of cardiac amyloidosis. Am J Cardiol, 1987,59(5):418–422
Kristen AV, Perz JB, Schonland SO, et al. Non-invasive predictors of survival in cardiac amyloidosis. Eur J Heart Fail, 2007,9(6–7):617–624
Tei C, Dujardin KS, Hodge DO, et al. Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol, 1996,28(3):658–664
Murtagh B, Hammill SC, Gertz MA, et al. Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement. Am J Cardiol, 2005, 95(4):535–537
Rahman JE, Helou EF, Gelzer-Bell R, et al. Noninvasive diagnosis of biopsy-proven cardiac amyloidosis. J Am Coll Cardiol, 2004,43(3):410–415
Hongo M, Yamamoto H, Kohda T, et al. Comparison of electrocardiographic findings in patients with AL (primary) amyloidosis and in familial amyloid polyneuropathy and anginal pain and their relation to histopathologic findings. Am J Cardiol, 2000,85(7):849–853
Song W, Yan HZ, Wang Y, et al. Radiographic findings of thorax in primary amyloidosis (analysis of 9 cases). Chin J Radiol (Chinese), 2000,34(3):196–198
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wang, J., Kong, X., Xu, H. et al. Noninvasive diagnosis of cardiac amyloidosis by MRI and echochardiography. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 30, 536–540 (2010). https://doi.org/10.1007/s11596-010-0464-y
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-010-0464-y