Thallium-201 myocardial SPECT findings at rest in sarcoidosis
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In 41 patients with sarcoidosis (diagnosed according to criteria recommended by the Committee on Diffuse Pulmonary Disease, Ministry of Health and Welfare, Japan 1988), thallium-201 (201Tl) myocardial SPECT was performed to investigate: (1) the ability of201Tl SPECT to detect cardiac involvement of sarcoidosis with images recorded at rest and 2 hours later, and (2) the relationships between201Tl myocardial SPECT findings and the activity of sarcoidosis or endomyocardial biopsy findings. As to the abnormal findings in201Tl myocardial SPECT, (1) a low density area was seen in 13 of 41 cases (31.7%) and non-uniform uptake was found in 17 cases (41.5%), (2) the mean washout ratio (n=39) was 16.5±7.4%, which is significantly (p < 0.05) lower than that found in normal subjects, 23.9±7.5 % (n=10). Of the 19 patients judged visually to be normal, 5 patients had a reduced mean washout ratio less than 12%. Thus, the incidence of abnormal findings including all types of abnormality, on201Tl myocardial SPECT in sarcoidosis was 63.4% (26/41 cases). In studying the relationship between201Tl myocardial SPECT findings and the activity of sarcoidosis (as measured by the serum ACE (angiotensin converting enzyme) or lysozyme level, or the presence of more than 30% symphocyte fraction in BALF (broncho-alveolar lavage fluid)), 20 (80%) of 25 cases with201Tl abnormality were judged to be active sarcoidosis, while only 6 (37.5%) of 16 cases with normal findings on201Tl SPECT were judged to be active. This suggests that there is a significant (p < 0.01) relationship between the presence or absence of an abnormal finding on201Tl myocardial SPECT and the activity of sarcoidosis. Among 13 patients examined by endomyocardial biopsy, 10 patients had abnormal findings on201Tl myocardial SPECT and 7 of these 10 patients had no histological evidence of cardiac sarcoidosis. In all of these 7 patients, however, sarcoidosis was judged to be active. This suggest that endomyocardial biopsy is of limited value in the diagnosis of cardiac sarcoidosis.
Key wordscardiac sarcoidosis 201Tl myocardial SPECT activity of sarcoidosis
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- 7.Ogawa H, Kinoshita N, Omori F, et al: A case of fetal myocardial sarcoidosis.Jap J Med 73: 1656–1664, 1984 (in Japanese)Google Scholar
- 9.Wynne J, Braunward E: The cardiomyopathies and myocarditis. Braunward E, eds. Heart disease;A textbook of cardiovascular medicine, 2nd ed, Saunders Philadelphia, pp. 1426–1427, 1984Google Scholar
- 12.Tachibana A, Iwai K, Matsui Y, et al: Cause of death in Japanese sarcoidosis.Committee report of Japanese sarcoidosis research report: 76, 1979 (in Japanese)Google Scholar
- 15.Haywood LJ, Sharma OP, Siegel ME, et al: Detection of myocardial sarcoidosis by Thallium 201 imaging.J Nat Med Assoc 74: 959–964, 1982Google Scholar
- 17.Fanburg BL, Pitt EA: Sarcoidosis. Murray JF & Nadel JA, eds.Textbook of respiratory Medicine, Saunders Philadelphia, pp. 1486–1500, 1988Google Scholar
- 18.Baarsuma GS, La-Hay E, Glasius E, et al: The predictive value of serum angiotensin converting enzyme and lysozyme levels in the diagnosis of ocular sarcoidosis.Am J Ophthalmol 104 (3): 211–217, 1987Google Scholar
- 22.Lemery R, McGoon MD, Edwards WD: Cardiac sarcoidosis: A potentially treatable form of myocarditis.Myo Clin Proc 60: 549–554, 1985Google Scholar