Cardiac amyloidosis other imaging findings: Difference between revisions
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==Overview== | ==Overview== | ||
The initial imaging modality | The initial [[imaging]] modality used in [[Patient|patients]] with suspected cardiac amyloidosis is [[Cardiac amyloidosis echocardiography|echocardiography]]. The [[diagnosis]] of ATTR cardiac amyloid can then be confirmed with a nuclear scan (99mTc-PYP imaging), which can then guide the management. | ||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
===Nuclear Cardiac | ===Nuclear Cardiac Scanning=== | ||
99mTechnetium-pyrophopshate (99mTc-PYP) is a widely available radiotracer. In conjunction with a cardiac or chest SPECT, 99mTc-PYP is infused and then the images are examined for visual interpretation and quantification of the degree of myocardial uptake. Qualitatively, myocardial uptake patterns are either absent, focal, diffuse, or focal on diffuse. A diffuse pattern is suggestive of ATTR cardiac amyloid. Quantitatively, radiotracer uptake in the the region of interest (ROI) in the heart (H) is compared to uptake in the contralateral lung (CL) at 1 hour after tracer injection, which yields an H/CL ratio. A ratio of | |||
* 99mTechnetium-pyrophopshate (99mTc-PYP) is a widely available [[radiotracer]]. | |||
* In conjunction with a [[Heart|cardiac]] or [[chest]] [[Single photon emission computed tomography|SPECT]], 99mTc-PYP is infused and then the images are examined for [[visual]] interpretation and quantification of the degree of myocardial uptake.<ref>{{Cite journal|last=Falk|first=RH|date=May 2014|title=How to image cardiac amyloidosis|url=https://www.ahajournals.org/doi/full/10.1161/CIRCIMAGING.113.001396?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed|journal=Circulation: Cardiovascular Imaging|volume=7|pages=552-562|via=}}</ref> | |||
* Qualitatively, [[Myocardium|myocardial]] uptake patterns are either absent, focal, diffuse, or focal on diffuse. | |||
* A diffuse pattern is suggestive of ATTR cardiac amyloid. | |||
* Quantitatively, [[radiotracer]] uptake in the the region of interest (ROI) in the heart (H) is compared to the uptake in the [[Anatomical terms of location|contralateral]] [[lung]] (CL) at 1 hour after [[Radiotracer|tracer]] [[Injection (medicine)|injection]], which yields an H/CL ratio. | |||
* A H/CL ratio of ≥ 1.5 is suggestive of ATTR cardiac amyloid. | |||
* Alternatively, uptake in the ROI can be visually compared to the [[rib]] at 3 hours after [[Radiotracer|tracer]] [[Injection (medicine)|injection]], with a visual score grade of > 2 (indicating uptake equal to that of the [[rib]]) suggestive of ATTR cardiac amyloid.<ref>{{Cite web|url=https://www.asnc.org/Files/Practice%20Resources/Practice%20Points/ASNC%20Practice%20Point-99mTechnetiumPyrophosphateImaging2016.pdf|title=ASNC Practice Points: 99mTechnetium-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 20:59, 30 October 2019
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Cardiac amyloidosis Microchapters |
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Treatment |
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Case Studies |
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Cardiac amyloidosis other imaging findings On the Web |
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American Roentgen Ray Society Images of Cardiac amyloidosis other imaging findings |
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Risk calculators and risk factors for Cardiac amyloidosis other imaging findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Aarti Narayan, M.B.B.S [3]
Overview
The initial imaging modality used in patients with suspected cardiac amyloidosis is echocardiography. The diagnosis of ATTR cardiac amyloid can then be confirmed with a nuclear scan (99mTc-PYP imaging), which can then guide the management.
Other Imaging Findings
Nuclear Cardiac Scanning
- 99mTechnetium-pyrophopshate (99mTc-PYP) is a widely available radiotracer.
- In conjunction with a cardiac or chest SPECT, 99mTc-PYP is infused and then the images are examined for visual interpretation and quantification of the degree of myocardial uptake.[1]
- Qualitatively, myocardial uptake patterns are either absent, focal, diffuse, or focal on diffuse.
- A diffuse pattern is suggestive of ATTR cardiac amyloid.
- Quantitatively, radiotracer uptake in the the region of interest (ROI) in the heart (H) is compared to the uptake in the contralateral lung (CL) at 1 hour after tracer injection, which yields an H/CL ratio.
- A H/CL ratio of ≥ 1.5 is suggestive of ATTR cardiac amyloid.
- Alternatively, uptake in the ROI can be visually compared to the rib at 3 hours after tracer injection, with a visual score grade of > 2 (indicating uptake equal to that of the rib) suggestive of ATTR cardiac amyloid.[2]
References
- ↑ Falk, RH (May 2014). "How to image cardiac amyloidosis". Circulation: Cardiovascular Imaging. 7: 552–562.
- ↑ "ASNC Practice Points: 99mTechnetium-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis" (PDF).