Ishibashi Kazuya, Takeda Mitsuo, Yamahara Yasuhiro
Department of Cardiology, Saiseikai Kyoto Hospital, Japan.
Intern Med. 2013;52(12):1341-5. doi: 10.2169/internalmedicine.52.9364.
We herein present a case of cardiac sarcoidosis with atrioventricular (AV) block that was evaluated using magnetic resonance imaging (MRI) before and after pacemaker implantation. An echocardiogram showed wall thinning in the basal septum. MRI showed late gadolinium enhancement in the interventricular septum and right ventricle. Fluorine-18-fluorodeoxyglucose positron emission tomography (PET) demonstrated abnormal uptake in the same area. An MR-conditional pacemaker was implanted to treat AV block. Steroid treatment resulted in the remission of the cardiac lesions and AV block, as confirmed by PET and MRI. MR-conditional pacemakers are thus considered to have great advantages in treating cardiac sarcoidosis with AV block.
我们在此呈现一例患有房室传导阻滞的心脏结节病病例，该病例在植入起搏器前后均接受了磁共振成像（MRI）评估。超声心动图显示基底间隔壁变薄。MRI显示室间隔和右心室有钆延迟强化。氟-18-氟脱氧葡萄糖正电子发射断层扫描（PET）显示同一区域有异常摄取。植入了一台磁共振兼容起搏器以治疗房室传导阻滞。类固醇治疗使心脏病变和房室传导阻滞得到缓解，PET和MRI证实了这一点。因此，磁共振兼容起搏器在治疗伴有房室传导阻滞的心脏结节病方面被认为具有很大优势。
