Tellier P, Valeyre D, Nitenberg A, Foult J M, Bedig G, Battesti J P
Eur J Nucl Med. 1985;11(6-7):201-4. doi: 10.1007/BF00279069.
A Tl 201 scan was performed on one young patient who met all of the criteria for the diagnosis sarcoidosis. A resting scan before treatment showed marked defects which were not resolved on the redistribution scan, thus leading to the diagnosis of cardiac sarcoidosis, which was also suspected from clinical signs. After dipyridamole infusion (0.142 mg/kg per minute over 4 min), his 201Tl scan was quite normal. Haemodynamic investigation showed a low coronary sinus blood flow with a low lactate extraction: these abnormalities were fully reversed by i.v. dipyridamole infusion. Afterwards, the patient was given oral dipyridamole (450 mg/day) over 4 weeks; at the end of this treatment, his resting 201Tl scan was quite normal. These results suggest that myocardial perfusion abnormalities in sarcoidosis may be reversible after pharmacological vasodilation. Thus, in order to assess cardiac sarcoidosis, a resting myocardial scan should be performed before a scan after dipyridamole infusion. These results may have clinical, pathophysiological and therapeutic implications with regard to cardiac sarcoidosis.
对一名符合结节病诊断所有标准的年轻患者进行了铊-201扫描。治疗前的静息扫描显示有明显缺损，再分布扫描时这些缺损未得到改善，因此诊断为心脏结节病，临床体征也提示了这一诊断。静脉输注双嘧达莫（4分钟内每分钟0.142毫克/千克）后，他的铊-201扫描结果完全正常。血流动力学检查显示冠状窦血流量低且乳酸摄取率低：静脉输注双嘧达莫后，这些异常完全得到逆转。之后，患者口服双嘧达莫（450毫克/天），持续4周；治疗结束时，他的静息铊-201扫描结果完全正常。这些结果表明，结节病中的心肌灌注异常在药物性血管扩张后可能是可逆的。因此，为了评估心脏结节病，应在双嘧达莫输注后的扫描前进行静息心肌扫描。这些结果可能对心脏结节病的临床、病理生理和治疗具有重要意义。
