Secondary amyloidosis other imaging findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
Tissue doppler echocardiography and myocardial strain rate imaging has been shown to be very sensitive for the assessment of myocardial dysfunction in restrictive cardiomyopathy. The developmend of serum amyloid P component (SAP) scans has given physicians the ability to specifically locate amyloid deposits.
Other Imaging Findings
Total Body SAP Scintigraphy
- Total body SAP component scintigraphy is another imaging modality that can be used in the workup and follow-up of patients with amyloid deposition.[1][2]
- This method has been observed to have high sensitivity (90%) and requires a low radioactive dose which makes its usage safe and effective.
- The radiolabeled SAP binds to AA amyloid and localizes its deposition semiquantitatively.
- However, this imaging modality is unable to identify deposits in hollow, diffuse, or small structures, such as the gastrointestinal tract, skin, and nerves.
- Also, SAP scintigraphy is unable to detect cardiac and lung involvement due to movement and blood content of these organs.
- In addition, all amyloid deposits contain serum amyloid P component (SAP), a circulating protein of the pentraxin family. Radionuclide SAP scans have been developed which can anatomically localize amyloid deposits in patients.[3]
- Tissue doppler and myocardial strain rate imaging has been proven to be very sensitive for the assessment of myocardial dysfunction in restrictive cardiomyopathy. Doppler studies may show abnormal wall motion early in the disease process.
- Abdominal ultrasound may reveal a swollen liver or spleen.
- Thyroid ultrasound can help diagnose thyroidal involvement by amyloidosis.
References
- ↑ Hawkins, Philip N. (2002). "Serum amyloid P component scintigraphy for diagnosis and monitoring amyloidosis". Current Opinion in Nephrology and Hypertension. 11 (6): 649–655. doi:10.1097/00041552-200211000-00013. ISSN 1062-4821.
- ↑ Hazenberg, Bouke P.C.; van Rijswijk, Martin H.; Piers, D. Albertus; Lub-de Hooge, Marjolijn N.; Vellenga, Edo; Haagsma, Elizabeth B.; Hawkins, Philip N.; Jager, Pieter L. (2006). "Diagnostic Performance of 123I-Labeled Serum Amyloid P Component Scintigraphy in Patients with Amyloidosis". The American Journal of Medicine. 119 (4): 355.e15–355.e24. doi:10.1016/j.amjmed.2005.08.043. ISSN 0002-9343.
- ↑ Pepys MB, Gallimore JR, Lloyd J, Li Z, Graham D, Taylor GW; et al. (2012). "Isolation and characterization of pharmaceutical grade human pentraxins, serum amyloid P component and C-reactive protein, for clinical use". J Immunol Methods. 384 (1–2): 92–102. doi:10.1016/j.jim.2012.07.013. PMC 4068106. PMID 22867744.