表心转移导致冠状动脉压缩和心肌梗塞在 [18F]FDG PET-CT上
Joshua Wilcox1,2, Ankur Gulati2,3, Elias Pintus4,5
1School of Cardiovascular Medicine & Sciences, King's College London.
Clinical nuclear medicine
|April 10, 2025
概括
一名接受免疫检查点抑制剂治疗的患者患上了耐火性心痛. 多模式成像,包括PET-CT,最终诊断出冠状动脉压缩是转移性癌症造成的,而不是心肌炎.
科学领域:
- 心脏瘤学是一门专业.
- 诊断成像诊断成像的使用
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以引起心脏不良事件.
- 区分ICI相关心肌炎与其他心脏疾病可能是具有挑战性的.
- 转移性癌症可以直接影响心脏结构.
研究的目的:
- 突出多模式成像在复杂的心脏瘤病例的诊断实用性.
- 为了说明在接受ICI治疗的患者中发生心痛的罕见原因.
- 强调全面成像在耐火性心脏症状的重要性.
主要方法:
- 一个64岁的女性患有转移性肺腺癌的病例报告.
- 最初的评估包括穿皮冠状动脉干预 (PCI) 和心脏磁共振成像 (CMR).
- 进一步的调查使用[18F]FDG PET-CT进行最终诊断.
主要成果:
- 最初的诊断建议基于症状和CMR的免疫检查点抑制剂 (ICI) 心肌炎.
- 耐火性心痛和持续的CMR发现尽管治疗促使先进的成像.
- [18F]FDG PET-CT揭示了心膜转移冠状动脉压缩是心肌梗塞的原因.
结论:
- 多模式成像,特别是[18F]FDG PET-CT,对于心脏瘤学的准确诊断至关重要.
- 脊心转移性冠状动脉压缩是ICI治疗心脏症状患者的关键差异诊断.
- 这一案例强调了先进的成像技术在癌症患者复杂心血管病例中的增量价值.
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