Chono Taiki, Harada Kohei, Asanuma Osamu
Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital.
Nihon Hoshasen Gijutsu Gakkai Zasshi. 2023 Dec 20;79(12):1370-1374. doi: 10.6009/jjrt.2023-1403. Epub 2023 Sep 26.
This is a case of a male patient in his 70s undergoing endocrine therapy for castration-resistant prostate cancer. On follow-up, he underwent whole-body bone scintigraphy for bone metastasis surveillance, and incidental cardiac uptake was identified. The findings were reported by the radiologist to the urologist, which was followed by a cardiac consultation. Late gadolinium enhancement magnetic resonance imaging did not detect typical patterns suggestive of cardiac amyloidosis. However, pyrophosphate scintigraphy identified cardiac uptake. These findings were indicative of transthyretin amyloid cardiomyopathy, and we confirmed the diagnosis by endomyocardial biopsy. In about 0.4-2.0 percentage of elderly patients, incidental cardiac uptake in bone scintigraphy has been reported. Bone scintigraphy is the most commonly utilized techniques among all scintigraphies. Thus, it is crucial that radiologists recognize and report the findings to establish a diagnosis of transthyretin amyloid cardiomyopathy.
这是一例70多岁的男性患者，正在接受去势抵抗性前列腺癌的内分泌治疗。在随访过程中，他接受了全身骨闪烁扫描以监测骨转移，结果偶然发现心脏有摄取。放射科医生将检查结果报告给了泌尿科医生，随后患者进行了心脏会诊。延迟钆增强磁共振成像未检测到提示心脏淀粉样变性的典型表现。然而，焦磷酸盐闪烁扫描发现心脏有摄取。这些发现提示转甲状腺素蛋白淀粉样心肌病，我们通过心内膜活检确诊了该病。据报道，在约0.4%-2.0%的老年患者中，骨闪烁扫描偶然发现心脏有摄取。骨闪烁扫描是所有闪烁扫描技术中最常用的。因此，放射科医生认识并报告这些发现以确诊转甲状腺素蛋白淀粉样心肌病至关重要。
