Abstract：
Cardiac amyloidosis, characterized by amyloid fibril deposition in the myocardium, leads to restrictive cardiomyopathy and heart failure. This review explores recent advancements in imaging techniques for diagnosing and managing cardiac amyloidosis, highlighting their clinical applications, strengths, and limitations. Echocardiography remains a primary, non-invasive imaging modality but lacks specificity. Cardiac MRI (CMR), with Late Gadolinium Enhancement (LGE) and T1 mapping, offers superior tissue characterization, though at higher costs and limited availability. Scintigraphy with Tc-99m-PYP reliably diagnoses transthyretin (TTR) amyloidosis but is less effective for light chain (AL) amyloidosis, necessitating complementary diagnostics. Amyloid-specific PET tracers, such as florbetapir and flutemetamol, provide precise imaging and quantitative assessment for both TTR and AL amyloidosis. Challenges include differentiating between TTR and AL amyloidosis, early disease detection, and standardizing imaging protocols. Future research should focus on developing novel tracers, integrating multimodality imaging, and leveraging AI to enhance diagnostic accuracy and personalized treatment. Advancements in imaging have improved cardiac amyloidosis management. A multimodal approach, incorporating echocardiography, CMR, scintigraphy, and PET tracers, offers comprehensive assessment. Continued innovation in tracers and AI applications promises further enhancements in diagnosis, early detection, and patient outcomes.
摘要：
心脏淀粉样变性,以淀粉样蛋白原纤维在心肌中沉积为特征，导致限制性心肌病和心力衰竭。这篇综述探讨了诊断和治疗心脏淀粉样变性的影像学技术的最新进展。突出它们的临床应用，优势,和限制。超声心动图仍然是主要的，非侵入性成像模式，但缺乏特异性。心脏MRI(CMR),使用晚钆增强(LGE)和T1映射，提供优越的组织表征，虽然成本较高，可用性有限。Tc-99m-PYP闪烁显像可靠地诊断甲状腺素运载蛋白（TTR）淀粉样变性，但对轻链（AL）淀粉样变性效果较差，需要补充诊断。淀粉样蛋白特异性PET示踪剂,如florbetapir和flutemetamol，为TTR和AL淀粉样变提供精确的成像和定量评估。挑战包括区分TTR和AL淀粉样变性，早期疾病检测，和标准化成像协议。未来的研究应该集中在开发新的示踪剂上，集成多模态成像，并利用人工智能来提高诊断准确性和个性化治疗。影像学的进步改善了心脏淀粉样变性的管理。多模式方法，结合超声心动图,CMR,闪烁显像,和PET示踪剂，提供全面的评估。示踪剂和人工智能应用的持续创新有望进一步增强诊断能力，早期发现,和患者结果。
