scholarly journals Is positron emission tomography enough to rule out cardiac sarcoidosis? A case report

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Siyi Huang ◽  
Siri Kunchakarra ◽  
Ankit Rathod
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Sarcoidosis ◽  
Premature Ventricular Contraction ◽  
Lymph Node Biopsy ◽  
Stress Perfusion ◽  
Myocardial Uptake ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Perfusion Cmr

Abstract Background Cardiac sarcoidosis (CS) is associated with poor prognosis, yet the clinical diagnosis is often challenging. Advanced cardiac imaging including cardiac magnetic resonance (CMR) and positron emission tomographic (PET) have emerged as useful modalities to diagnose CS. Case summary A 66-year-old woman presented with palpitations. A 24-h Holter monitor detected a high premature ventricular contraction burden of 25.6%. She underwent two transthoracic echocardiograms; both showed normal results. Stress perfusion CMR did not show any evidence of ischaemic aetiology; however, myocardial lesions detected by late gadolinium enhancement (LGE) imaging raised suspicion for CS. While there was no myocardial uptake of fluorodeoxyglucose (FDG) in subsequent cardiac PET, high FDG uptake was seen in hilar lymph nodes. Lymph node biopsy confirmed the diagnosis of sarcoidosis. Discussion Cardiac magnetic resonance and PET imaging are designed to evaluate different aspects CS pathophysiology. The characteristic LGE in the absence of increased FDG uptake suggested inactive CS with residual myocardial scarring.

scholarly journals Automated Quantitative Stress Perfusion Cardiac Magnetic Resonance in Pediatric Patients

2021 ◽  
Vol 9 ◽  
Author(s):  
Cian M. Scannell ◽  
Hadeer Hasaneen ◽  
Gerald Greil ◽  
Tarique Hussain ◽  
Reza Razavi ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Heart Diseases ◽  
Stress Perfusion ◽  
Coronary Perfusion ◽  
Cardiac Events ◽  
Large Aneurysm ◽  
Quantitative Stress ◽  
Perfusion Cmr

Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients.Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults.Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002].Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

scholarly journals Hybrid positron emission tomography-magnetic resonance imaging for assessing different stages of cardiac impairment in patients with Anderson–Fabry disease: AFFINITY study group

2019 ◽  
Vol 20 (9) ◽  
pp. 1004-1011 ◽  
Author(s):  
Massimo Imbriaco ◽  
Carmela Nappi ◽  
Andrea Ponsiglione ◽  
Antonio Pisani ◽  
Serena Dell’Aversana ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Magnetic Resonance ◽  
Fabry Disease ◽  
T1 Mapping ◽  
Emission Tomography ◽  
Myocardial Uptake ◽  
Fdg Uptake ◽  
Control Subjects ◽  
Positron Emission ◽  
18F Fdg

Abstract Aims Anderson–Fabry disease (AFD) is an X-linked lysosomal storage disorder associated with multi-organ dysfunction. While native myocardial T1 mapping by magnetic resonance (MR) allow non-invasive measurement of myocyte sphingolipid accumulation, 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and MR are able to identify different pathological patterns of disease progression. We investigated the relationship between T1 mapping and 18F-FDG uptake by hybrid PET-MR cardiac imaging in AFD female patients. Methods and results Twenty AFD females without cardiac symptoms underwent cardiac PET-MR using 18F-FDG for glucose uptake. In all patients and in seven age- and sex-matched control subjects, T1 mapping was performed using native T1 Modified Look-Locker Inversion-recovery prototype sequences. 18F-FDG myocardial uptake was quantified by measuring the coefficient of variation (COV) of the standardized uptake value using a 17-segment model. T1 values of AFD patients were lower compared with control subjects (1236 ± 49 ms vs. 1334 ± 27 ms, P < 0.0001). Focal 18F-FDG uptake with COV >0.17 was detected in seven patients. COV was 0.32 ± 0.1 in patients with focal 18F-FDG uptake and 0.12 ± 0.04 in those without (P < 0.001). Patients with COV >0.17 had higher T1 values of lateral segments of the mid ventricular wall, compared with those with COV ≤0.17 (1216 ± 22 ms vs. 1160 ± 59 ms, P < 0.05). Conclusion In females with AFD, focal 18F-FDG uptake with a trend towards a pseudo-normalization of abnormal T1 mapping values, may represent an intermediate stage before the development of myocardial fibrosis. These findings suggest a potential relationship between progressive myocyte sphingolipid accumulation and inflammation.

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