Amyloidosis is a local or systemic disease caused by the deposition of misfolded proteins outside the cell, with rapid progression, and dire prognosis. Common types of cardiac amyloidosis are monoclonal immunoglobulin light chain amyloidosis (AL-CA) and transthyretin cardiac amyloidosis (ATTR-CA). Nuclear medicine examinations can be accurate, rapid, and non-invasive to help diagnose diseases and can effectively predict the prognosis of patients with CA. Technetium (99Tcm)-labeled bisphosphonate imaging has been included in the consensus of experts and has become the first-line imaging method for the diagnosis of ATTR-CA. 123I-metaiodoenzylguanidine (MIBG) as a norepinephrine analogue can effectively assess cardiac sympathetic innervation in patients with CA. Aβ- amyloid imaging agents such as 11C-pittsburgh compound B and 18F-flubetaben are expected to be new techniques for diagnosing AL-CA and incorporating them into cardiac staging systems for AL-CA patients in the future. New imaging agents such as 18F-NaF has been widely used in the diagnosis, treatment response monitoring, and prognosis assessment of CA. Summarizing the research value of nuclide imaging in CA may provide new ideas for clinical realization of early detection of CA and accurate assessment of disease prognosis.
淀粉样变性是由错误折叠的蛋白质沉积在细胞外引起的局部或全身性疾病，具有进展快，预后差的特点。心脏淀粉样变(cardiac amyloidosis，CA)常见的类型为单克隆免疫球蛋白轻链型淀粉样变(immunoglobulin light chain cardiac amyloidosis，AL-CA)和转甲状腺素蛋白型淀粉样变(transthyretincardiac amyloidosis，ATTR-CA)。核医学检查可准确、快速、无创性地辅助诊断CA且可有效预测CA患者预后。其中锝标双膦酸盐显像已被纳入专家共识，成为诊断ATTR-CA的一线方式。123I-间碘苄基胍(metaiodoenzylguanidine，MIBG)是去甲肾上腺素类似物，可有效评估CA患者心脏交感神经失支配状况。11C-匹兹堡化合物Ｂ和18F-氟比他班等Aβ-淀粉样蛋白显像剂在未来有望成为诊断AL-CA的新技术并纳入AL-CA患者的心脏分期系统。18F-NaF等新型显像剂在CA的诊断、疗效及预后评估中的应用日益广泛。总结核素显像在CA中的研究价值，可为临床中早期检测CA、精准评估疾病预后提供新思路。.
Keywords: cardiac amyloidosis; diagnosis; imaging agent; nuclide scintigraphy; prognosis.