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Vascular imaging with positron emission tomography.
Journal of Internal Medicine ( IF 9.0 ) Pub Date : 2011-05-18 , DOI: 10.1111/j.1365-2796.2011.02392.x
F Joshi 1 , D Rosenbaum , S Bordes , J H F Rudd
Affiliation  

Atherosclerosis is an inflammatory disease that causes most myocardial infarctions, strokes and acute coronary syndromes. Despite the identification of multiple risk factors and widespread use of drug therapies, it still remains a global health concern with associated costs. Although angiography is established as the gold standard means of detecting coronary artery stenosis, it does not image the vessel wall itself, reporting only on its consequences such as luminal narrowing and obstruction. MRI and computed tomography provide more information about the plaque structure, but recently positron emission tomography (PET) imaging using [(18) F]-fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial inflammation. This results from the ability of FDG-PET to highlight areas of high glucose metabolism, a feature of macrophages within atherosclerosis, particularly in high-risk plaques. It is suggested that the degree of FDG accumulation in the vessel wall reflects underlying inflammation levels and that tracking any changes in FDG uptake over time or with drug therapy might be a way of getting an early efficacy readout for novel anti-atherosclerotic drugs. Early reports also demonstrate that FDG uptake is correlated with the number of cardiovascular risk factors and possibly even the risk of future cardiovascular events. This review will outline the evidence base, shortcomings and emerging applications for FDG-PET in vascular imaging. Alternative PET tracers and other candidate imaging modalities for measuring vascular inflammation will also be discussed.

中文翻译:

血管成像与正电子发射断层扫描。

动脉粥样硬化是一种炎症性疾病,可导致大多数心肌梗塞、中风和急性冠状动脉综合征。尽管确定了多种风险因素并广泛使用药物疗法,但它仍然是一个具有相关成本的全球健康问题。尽管血管造影被确立为检测冠状动脉狭窄的金标准手段,但它并不对血管壁本身进行成像,仅报告其后果,例如管腔变窄和阻塞。MRI 和计算机断层扫描提供了关于斑块结构的更多信息,但最近提倡使用 [(18) F]-氟脱氧葡萄糖 (FDG) 的正电子发射断层扫描 (PET) 成像作为测量动脉炎症的一种手段。这是由于 FDG-PET 能够突出高葡萄糖代谢区域的能力,动脉粥样硬化中巨噬细胞的一个特征,特别是在高风险斑块中。有人建议,血管壁中 FDG 积累的程度反映了潜在的炎症水平,并且跟踪 FDG 摄取随时间或药物治疗的任何变化可能是获得新型抗动脉粥样硬化药物早期疗效读数的一种方式。早期报告还表明,FDG 摄取与心血管危险因素的数量相关,甚至可能与未来心血管事件的风险相关。本综述将概述 FDG-PET 在血管成像中的证据基础、缺点和新兴应用。还将讨论用于测量血管炎症的替代 PET 示踪剂和其​​他候选成像方式。有人建议,血管壁中 FDG 积累的程度反映了潜在的炎症水平,并且跟踪 FDG 摄取随时间或药物治疗的任何变化可能是获得新型抗动脉粥样硬化药物早期疗效读数的一种方式。早期报告还表明,FDG 摄取与心血管危险因素的数量相关,甚至可能与未来发生心血管事件的风险相关。本综述将概述 FDG-PET 在血管成像中的证据基础、缺点和新兴应用。还将讨论用于测量血管炎症的替代 PET 示踪剂和其​​他候选成像方式。有人建议,血管壁中 FDG 积累的程度反映了潜在的炎症水平,并且跟踪 FDG 摄取随时间或药物治疗的任何变化可能是获得新型抗动脉粥样硬化药物早期疗效读数的一种方式。早期报告还表明,FDG 摄取与心血管危险因素的数量相关,甚至可能与未来心血管事件的风险相关。本综述将概述 FDG-PET 在血管成像中的证据基础、缺点和新兴应用。还将讨论用于测量血管炎症的替代 PET 示踪剂和其​​他候选成像方式。
更新日期:2019-11-01
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