Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
J Nucl Cardiol. 2023 Feb;30(1):280-289. doi: 10.1007/s12350-022-03034-0. Epub 2022 Jul 8.
Diagnostic guidelines for isolated cardiac sarcoidosis (iCS) were first proposed in 2016, but there are few reports on the imaging and prognosis of iCS. This study aimed to evaluate the use of F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging in predicting iCS prognosis.
We retrospectively reviewed the clinical and imaging data of 306 consecutive patients with suspected CS who underwent FDG PET/CT with a dedicated preparation protocol and included 82 patients (55 with systemic sarcoidosis including cardiac involvement [sCS], 27 with iCS) in the study. We compared the FDG PET/CT findings between the two groups. We examined the relationship between the CS type and the rate of adverse cardiac events. The iCS group had a significantly lower target-to-background ratio than the sCS group (P = 0.0010). The event-free survival rate was significantly lower in the iCS group than the sCS group (log-rank test, P < 0.0001). iCS was identified as an independent prognostic factor for adverse events (hazard ratio 3.82, P = 0.0059).
iCS was an independent prognostic factor for adverse cardiac events in patients with CS. The clinical diagnosis of iCS based on FDG PET/CT and new guidelines may be important.
孤立性心脏结节病（iCS）的诊断指南于 2016 年首次提出，但关于 iCS 的影像学表现和预后的报道较少。本研究旨在评估 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）成像在预测 iCS 预后中的作用。
我们回顾性分析了 306 例疑似 CS 患者的临床和影像学资料，这些患者均采用专用准备方案进行 FDG PET/CT 检查，其中 82 例（55 例系统性结节病包括心脏受累 [sCS]，27 例 iCS）纳入本研究。我们比较了两组 FDG PET/CT 结果。我们检查了 CS 类型与不良心脏事件发生率之间的关系。iCS 组的靶-背景比显著低于 sCS 组（P = 0.0010）。iCS 组的无事件生存率显著低于 sCS 组（对数秩检验，P < 0.0001）。iCS 是不良事件的独立预后因素（危险比 3.82，P = 0.0059）。
iCS 是 CS 患者不良心脏事件的独立预后因素。基于 FDG PET/CT 和新指南的 iCS 临床诊断可能很重要。
