摘要淀粉样变是指淀粉样蛋白异常沉积引起的疾病,累及心肌的淀粉样变主要为轻链型淀粉样变(AL)及转甲状腺素蛋白淀粉样变(ATTR).不同类型的心肌淀粉样变的预后及治疗方法不同,因此早期诊断、分型及治疗尤为重要.核医学显像可以对心肌淀粉样变进行无创性诊断及分型,骨显像剂对于ATTR诊断的灵敏度和特异性较高,并且对预后判断有一定的价值;交感神经显像剂可检测心脏交感神经支配状况,可比骨显像更早地显示淀粉样变的心肌受累;淀粉样蛋白特异性显像剂最早用于神经系统淀粉样变的诊断,在心肌淀粉样变的初步研究中也获得了不错的结果,并且对AL的诊断特异性稍好于ATTR.该文介绍了核医学显像方法在心肌淀粉样变中的应用进展.

abstractsAmyloidosis is a disease caused by abnormal deposition of amyloid protein, and the main types of amyloidosis involving myocardium are light chain amyloidosis (AL) and transthyretin-related amy-loidosis (ATTR). Different types of myocardial amyloidosis have different prognosis and treatment methods. Therefore, early diagnosis and classification are particularly important. Nuclear medical imaging can diag-nose and classify myocardial amyloidosis noninvasively. Radiotracers for bone scintigraphy has high sensitivi-ty and specificity for the diagnosis of ATTR, and have certain value for prognosis. Sympathetic innervation imaging tracers can detect cardiac sympathetic innervation, which may show myocardial involvement of amy-loidosis earlier than bone scintigraphy. Amyloid protein specific imaging agent, which was first used in the diagnosis of amyloidosis in nervous system, has also yielded good results from preliminary studies in myocar-dial amyloidosis, and the diagnostic specificity in AL is slightly better than that in ATTR. This review intro-duces the application of nuclear medical imaging in myocardial amyloidosis.