Pop Sabin G, Hägler Eva, Popescu Cristina, Burger Irene A, Sauter Alexander W
Department of Nuclear Medicine, Cantonal Hospital Baden, Partner Hospital for Research and Teaching of the Medical Faculty of the University of Zurich, Baden, 5404, Switzerland.
Department of Cardiology, Cantonal Hospital Baden, Partner Hospital for Research and Teaching of the Medical Faculty of the University of Zurich, Baden, 5404, Switzerland.
Int J Cardiovasc Imaging. 2025 Apr;41(4):817-819. doi: 10.1007/s10554-024-03315-4. Epub 2025 Jan 8.
A 65-year-old woman with a history of ductal mammary carcinoma and recent autonomic dysfunction underwent a Rb-82 chloride (RbCl) cardiac PET/CT scan that showed no ischemia or scarring, but significantly reduced myocardial flow reserve (MFR) (global: 1.5) and a CAC-Score of 0. The patient's chemotherapy history (paclitaxel, carboplatin, epirubicin, pembrolizumab 2 years before) with elevated Troponin T and NT-pro-BNP levels at that time, and now reduced MFR with 0 CAC suggests cancer-therapy-related cardiotoxicity. An important differential diagnosis to the more common CAD-associated microvascular disease. Furthermore, tumor recurrence with a PET-avid lymph node metastasis was found additionally.
一名65岁女性，有导管性乳腺癌病史且近期出现自主神经功能障碍，接受了氯化铷（RbCl）心肌PET/CT扫描，结果显示无缺血或瘢痕形成，但心肌血流储备（MFR）显著降低（整体：1.5），冠状动脉钙化积分（CAC-Score）为0。患者有化疗史（两年前使用紫杉醇、卡铂、表柔比星、帕博利珠单抗），当时肌钙蛋白T和N末端B型利钠肽原（NT-pro-BNP）水平升高，现在MFR降低且CAC为0，提示存在癌症治疗相关的心脏毒性。这是一种重要的鉴别诊断，与更常见的冠状动脉疾病（CAD）相关的微血管疾病相鉴别。此外，还发现了PET显示为高摄取的淋巴结转移灶，提示肿瘤复发。
