Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Nucl Cardiol. 2018 Apr;25(2):443-456. doi: 10.1007/s12350-018-1217-8. Epub 2018 Feb 8.
Cardiac sarcoidosis has long been an evasive diagnosis with a spectrum of clinical presentations that extend from asymptomatic to ventricular arrhythmias and sudden cardiac death. The diagnosis has traditionally relied on histology which suffers from the low sensitivity of endomyocardial biopsy due to the patchy nature of the disease in addition to its invasive nature. Due to significant advancements in imaging, it is now possible to accurately identify cardiac sarcoidosis using non-invasive imaging modalities even without histological confirmation. Emerging guidelines are highlighting the role of multimodality imaging in the diagnosis and management of this challenging entity. We present the case of a 36-year-old man known to have sarcoidosis in which a variety of imaging modalities not only assisted in the diagnosis of cardiac sarcoidosis, but also played a key role in the monitoring of disease activity and response to therapy.
心脏结节病的诊断一直难以明确,其临床表现从无症状到室性心律失常和心脏性猝死不等,范围广泛。传统上,心脏结节病的诊断依赖于组织学,由于疾病的局灶性以及其侵袭性,心内膜心肌活检的敏感性较低,因此存在一定的局限性。由于影像学的显著进步,现在即使没有组织学证实,也可以使用非侵入性影像学模式准确识别心脏结节病。新出现的指南强调了多模式影像学在诊断和管理这种具有挑战性实体中的作用。我们报告了 1 例 36 岁男性的病例,该患者已知患有结节病,各种影像学模式不仅有助于诊断心脏结节病,而且在监测疾病活动和对治疗的反应方面也发挥了关键作用。