Diagnosis and Evaluation of Cardiac Amyloidosis with Noninvasive Multimodality Imaging

Abstract

Cardiac amyloidosis (CA) is a group of restrictive cardiomyopathies that have received increasing attention and awareness. With the advancement of noninvasive multimodality imaging techniques, the diagnostic efficacy and comprehensive assessment of CA have rapidly evolved. Here, we present two cases in which better diagnosis and evaluation were achieved using multimodality imaging techniques.Two patients with CA were diagnosed with transthyretin CA and immunoglobulin light-chain CA using clinical data, laboratory tests, ultrasound, nuclear medicine, coronary CT angiography, and cardiovascular magnetic resonance, respectively. This not only elucidated the diagnosis of CA but also provided a comprehensive and in-depth diagnosis of these two patients with CA using noninvasive multimodality imaging techniques through the detection of cardiac morphology and size, left ventricular function, myocardial injury, and coronary microvascular function. The disease processes and characteristics of these patients were comprehensively evaluated, especially the classified diagnosis of CA via radionuclide 99m Tc-PYP imaging and measurement of coronary flow reserve via quantitative radionuclide myocardial perfusion imaging for the diagnosis and evaluation of CA.Modern multimodality noninvasive imaging can complement each other's information and strengths and play important roles in the early diagnosis and treatment of patients with CA.