摘要
目的探讨Al^(18)F-1,4,7-三氮杂环壬烷-1,4,7-三乙酸(NOTA)-成纤维细胞激活蛋白抑制剂(FAPI)PET/CT显像对轻链型心脏淀粉样变(AL-CA)的诊断价值。方法前瞻性研究2021年9至12月于首都医科大学附属北京朝阳医院确诊为AL-CA的8例[5例合并多发性骨髓瘤(MM)]患者的临床资料,其中男性7例、女性1例,年龄(62.9±5.6)岁。分别招募与AL-CA患者性别和年龄匹配的5名健康志愿者和5例MM患者作为对照。研究共分为4组:AL-CA+MM组(AL-CA伴MM)5例、AL-only组(AL-CA不伴MM)3例、MM对照组(MM不伴AL-CA)5例、健康对照组5名。所有受试者均接受Al^(18)F-NOTA-FAPI PET/CT显像。分析4组受试者的实验室检查指标[B型利钠肽(BNP)水平]、心脏超声数据和Al^(18)F-NOTA-FAPI PET/CT显像结果。多组间计量资料的比较采用LSD检验或Kruskal Wallis检验。2组间计量资料的比较采用两独立样本t检验(方差齐),计数资料的比较采用χ^(2)检验。结果与MM对照组相比,AL-only组BNP水平升高,差异有统计学意义[(259.0±40.0)pg/ml对(19.2±15.7)pg/ml,t=9.928,P<0.05];AL-CA+MM组左心室室间隔厚度和左心室后壁厚度增加,差异均有统计学意义[(13.9±1.1)mm对(10.8±0.3)mm,t=6.197,P<0.05;(13.7±0.9)mm对(10.3±0.6)mm,t=6.774,P<0.05]。Al^(18)F-NOTA-FAPI PET/CT显像结果显示:AL-CA+MM组3例(3/5,60.0%)患者和AL-only组3例(3/3,100.0%)患者左心室心肌Al^(18)F-NOTA-FAPI摄取均为阳性;MM对照组4例(4/5,80.0%)患者和健康对照组5名(5/5,100.0%)受试者左心室心肌Al^(18)F-NOTA-FAPI摄取均为阴性。AL-only组左心室心肌最大标准化摄取值(SUVmax)和靶本底比值(T/B)均高于健康对照组[SUVmax:(4.1±1.1)对(2.1±0.2),t=3.234,P=0.081;T/B:(4.7±0.6)对(2.2±0.4),t=6.748,P=0.001]。AL-CA+MM组左心室心肌SUVmax和T/B均高于MM对照组[SUV max:(4.2±1.8)对(2.5±1.4),t=1.699,P=0.128;T/B:(4.2±2.1)对(3.0±1.2),t=1.120,P=0.295]。AL-CA+MM组左心室心肌SUVmax和T/B均高于健康对照组[SUVmax:(4.2±1.8)对(2.
Objective To explore the diagnostic value of Al^(18)F-1,4,7-triazacyclononane-1,4,7-triacetic acid(NOTA)-fibroblast activation protein inhibitor(FAPI)PET/CT imaging in light chain cardiac amyloidosis(AL-CA).Methods The clinical data of 8 patients(7 males and 1 female,aged(62.9±5.6)years)diagnosed with AL-CA in Beijing Chao-Yang Hospital,Capital Medical University from September to December 2021 were prospectively studied.Five healthy volunteers and 5 patients with multiple myeloma(MM),who matched the gender and age with AL-CA patients,were recruited as controls.All subjects were divided into 4 groups:5 cases in the AL-CA+MM group(AL-CA with MM),3 cases in the AL-only group(AL-CA without MM),5 cases in the MM control group(MM without AL-CA),and 5 cases in the healthy control group.All subjects underwent Al^(18)F-NOTA-FAPI PET/CT imaging.Laboratory index type B natriuretic peptide(BNP)level,echocardiography data,and Al^(18)F-NOTA-FAPI PET/CT imaging results were analyzed.Measurement data were compared among the 4 groups by using LSD or Kruskal-Wallis test and between 2 groups by independent samples t-test(homogeneity of variance).Enumeration data were compared by χ^(2) test.Results BNP level in the AL-only group was higher than that in the MM control group,and the difference was statistically significant((259.0±40.0)pg/ml vs.(19.2±15.7)pg/ml,t=9.928,P<0.05).The left ventricular interventricular septum thickness and the left ventricular posterior wall thickness increased in the AL-CA+MM group,and the differences were statistically significant((13.9±1.1)mm vs.(10.8±0.3)mm,t=6.197,P<0.05;(13.7±0.9)mm vs.(10.3±0.6)mm,t=6.774,P<0.05).Al^(18)F-NOTA-FAPI PET/CT imaging results showed that the Al^(18)F-NOTA-FAPI uptake of the left ventricular myocardium was positive in 3 cases(3/5,60.0%)of the AL-CA+MM group and 3 cases(3/3,100.0%)of the AL-only group.The left ventricular myocardium Al^(18)F-NOTA-FAPI uptake was negative in 4 patients(4/5,80.0%)of the MM control group and 5 subjects(5/5,100.0%)of the healthy contro
作者
苏瑶
王丽
刘爱军
杨敏福
Su Yao;Wang Li;Liu Aijun;Yang Minfu(Department of Nuclear Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Hematology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《国际放射医学核医学杂志》
2024年第1期15-21,共7页
International Journal of Radiation Medicine and Nuclear Medicine
基金
北京市医院管理局临床医学发展专项(ZYLX202105)
首都医科大学附属北京朝阳医院多学科临床研究创新团队项目(CYDXK202214)。
