Department of Radiology, Yawatahama City General Hospital, Ehime, Japan.
Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Clin Nucl Med. 2024 Dec 1;49(12):1136-1138. doi: 10.1097/RLU.0000000000005521.
Wild-type transthyretin amyloid (ATTRwt) deposits in most organs, mainly the heart, ligaments, and tenosynovium. Orthopedic diseases due to ATTRwt deposits often precede overt ATTRwt cardiomyopathy. 99mTc-PYP scintigraphy is highly sensitive in detecting myocardial and extracardiac ATTRwt deposits. However, there are few reports of extracardiac ATTRwt deposits before myocardial deposits confirmed by imaging modalities. We report a case of atrial fibrillation-related heart failure in which 99mTc-PYP scintigraphy showed tracer uptake in extracardiac soft tissues but not in the myocardium, and a biopsy of soft tissues with tracer uptake confirmed ATTRwt deposits. 99mTc-PYP scintigraphy can image extracardiac ATTRwt deposits before myocardial deposits.
野生型转甲状腺素蛋白淀粉样变（ATTRwt）在大多数器官中沉积，主要在心脏、韧带和腱膜。由于 ATTRwt 沉积引起的骨科疾病常先于明显的 ATTRwt 心肌病。99mTc-PYP 闪烁显像术在检测心肌和心脏外的 ATTRwt 沉积方面具有高度敏感性。然而，在通过影像学手段证实心肌沉积之前，有很少关于心脏外 ATTRwt 沉积的报道。我们报告了一例与心房颤动相关的心衰病例，99mTc-PYP 闪烁显像术显示心脏外软组织有示踪剂摄取，但心肌没有摄取，而有示踪剂摄取的软组织活检证实存在 ATTRwt 沉积。99mTc-PYP 闪烁显像术可在心肌沉积前显示心脏外 ATTRwt 沉积。
