Usefulness of late gadolinium enhancement combined with MRI and 67-Ga scintigraphy in the diagnosis of cardiac sarcoidosis and disease activity evaluation.
We report a case in which late gadolinium enhancement (LGE) and 67-Ga scintigraphy were useful for the diagnosis of cardiac sarcoidosis and for the evaluation of the disease activity. The patient was a 60-year-old woman who had been diagnosed as having eye sarcoidosis when she was 48. Two years previously her electrocardiogram had shown abnormalities but the coronary angiography had shown normal coronary arteries; however, an aneurysm was detected in the apical portion by left ventriculography. A II degree AV block was noted on the electrocardiogram and she was referred to us for further detailed evaluation. Since the biopsy findings of skin eruptions on both eyelids indicated an epithelial cell granuloma, she was diagnosed as having cutaneous sarcoidosis. On the 67-Ga scintigram, myocardial accumulation of gallium was recognized, and on cardiovascular magnetic resonance (CMR), LGE was recognized. She was diagnosed as cardiac sarcoidosis and steroid therapy started with 30 mg prednisolone. The myocardial accumulation of gallium on the 67-Ga scintigram disappeared after the 30th day of steroid therapy. On the other hand, no changes in LGE patterns were seen after steroid therapy. In this case, LGE was useful for the diagnosis of cardiac sarcoidosis, and 67-Ga scintigram was useful for the evaluation of the disease activity. This case shows that both imaging techniques are important for the diagnosis of cardiac sarcoidosis and evaluation of the disease.
Kiuchi
Shintaro
S
Division of Cardiology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan.
Teraoka
Kunihiko
K
Koizumi
Kiyoshi
K
Takazawa
Kenji
K
Yamashina
Akira
A
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D005710:Gallium Radioisotopes; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012507:Sarcoidosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D005710:Gallium Radioisotopes; D011239:Prednisolone; D019786:Gadolinium DTPA