Matsuo Shinro, Nakajima Kenichi, Kinuya Seigo, Sato Yuichi, Matsumoto Naoya, Horie Minoru
Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa;
Exp Clin Cardiol. 2008 Summer;13(2):93-5.
A 49-year-old woman was admitted to hospital because of heart failure. She was diagnosed as having mitochondrial cardiomyopathy and diabetes mellitus. Echocardiography revealed a hypertrophic and poorly contracting left ventricle. A diagnosis of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes was established by muscle biopsy. She underwent technetium-99m-sestamibi ((99m)Tc-MIBI) and beta-methyl-p-(123)I-iodophenyl-pentadecanoic acid ((123)I-BMIPP) scintigraphic examinations. (99m)Tc-MIBI single-photon emission computed tomography revealed reduced tracer uptake in the hypertrophic left ventricular inferior wall. In contrast, there was an increase in (123)I-BMIPP uptake in the in the region of reduced (99m)Tc-MIBI uptake ((99m)Tc-MIBI/(123)I-BMIPP mismatch). There was rapid washout of (99m)Tc-MIBI from the myocardium (washout rate increased by 30%). Decreased (99m)Tc-MIBI and increased (123)I-BMIPP uptake ((99m)Tc-MIBI/(123)I-BMIPP mismatch) were the characteristics of cardiac involvement in mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes.
一名49岁女性因心力衰竭入院。她被诊断为患有线粒体心肌病和糖尿病。超声心动图显示左心室肥厚且收缩功能差。通过肌肉活检确诊为线粒体肌病、脑病、乳酸性酸中毒和卒中样发作。她接受了锝-99m-甲氧基异丁基异腈（（99m）Tc-MIBI）和β-甲基-p-（123）I-碘苯基十五烷酸（（123）I-BMIPP）闪烁显像检查。（99m）Tc-MIBI单光子发射计算机断层扫描显示肥厚的左心室下壁示踪剂摄取减少。相比之下，在（99m）Tc-MIBI摄取减少的区域（（99m）Tc-MIBI/（123）I-BMIPP不匹配），（123）I-BMIPP摄取增加。心肌中（99m）Tc-MIBI快速洗脱（洗脱率增加30%）。（99m）Tc-MIBI减少和（123）I-BMIPP摄取增加（（99m）Tc-MIBI/（123）I-BMIPP不匹配）是线粒体肌病、脑病、乳酸性酸中毒和卒中样发作心脏受累的特征。
