Case Report: Dual-Energy Computed Tomography of Cardiac Changes in IgG4-Related Disease

Ying Wang; Hui Zhou; Ping Hu; Jie Zhao; Yitao Mao; Zhixiao Li; Xi Zhao

doi:10.3389/fcvm.2022.792531

Case Report: Dual-Energy Computed Tomography of Cardiac Changes in IgG4-Related Disease

Front Cardiovasc Med. 2022 Mar 4:9:792531. doi: 10.3389/fcvm.2022.792531. eCollection 2022.

Authors

Ying Wang^{1

2}, Hui Zhou^{1

2}, Ping Hu^{1

2}, Jie Zhao^{1

2}, Yitao Mao^{1

2}, Zhixiao Li^{1

2}, Xi Zhao³

Affiliations

¹ Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
³ Siemens Healthineers China, Shanghai, China.

Abstract

Background: Dual-energy computed tomography (DECT) is used in coronary plaque characterization, myocardial perfusion imaging, and pulmonary embolism diagnosis; however, there is no relevant research on DECT in IgG4-related diseases (IgG4-RD) involving the coronary artery. We are the first to report DECT findings of cardiac morphology and function in IgG4-RD.

Patient findings: Multimodality cardiovascular imaging from a 63-year-old male patient, who presented with IgG4-related pancreatitis, was analyzed. An iodine map and spectral curves were obtained from the DECT, which can help to distinguish between non-calcified plaques and IgG4 lesions of the coronary artery, noninvasive FFR_CT (fractional flow reserve derived from coronary computed tomography angiography) and ECV (extracellular volume fraction) demonstrated myocardial ischemia and myocardial fibrosis, respectively.

Conclusion: The DECT can detect coronary artery tumor-like lesions caused by IgG4-RD and simultaneously assess the morphological, functional, and histological characteristics of the myocardium. This may help to guide individualized and timely treatment and avoid potentially life-threatening complications.

Keywords: IgG4-related disease (IgG4-RD); coronary computed tomography angiography (CCTA); coronary heart disease; dual energy computed tomography (DECT); myocardial fibrosis (MF); myocardial ischemia (MI).

Publication types

Case Reports