Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease
Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease
复制标题
双时间点心肌~(18)F-FDG显像在冠状动脉疾病检测中的应用
DOI：
10.1186/s12872-017-0554-x
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发表时间：
2017-05-10
影响因子：
2.1
通讯作者：
Yang, Min-Fu
中科院分区：
文献类型：
--
作者：
Dou, Ke-Fei;Gao, Xiao-Jin;Yang, Min-Fu
背景：空腹状态下，冠心病患者心肌18 F-脱氧葡萄糖（18 F-FDG）摄取增加。方法：对52例临床疑诊冠心病的患者在空腹状态下进行18F-FDG PET显像，并对18F-FDG显像结果进行统计学分析。在单次给予18F-FDG后2小时内进行两次18F-FDG成像（双时间点成像），并在首次成像后进行运动试验干预。根据18F-FDG分布模式分类确定18F-FDG摄取异常，分析两次PET显像之间18F-FDG分布的变化，在运动峰值时注射99 mTc-Sestamibi，18F-FDG显像后行心肌灌注显像（MPI）。结果：54.8%（17/31）的冠心病患者和36.2%（21/58）的冠状动脉狭窄患者出现运动性18F-FDG摄取异常。根据18F-FDG分布模式的分类，运动18F-FDG显像诊断冠心病的敏感性和特异性分别为80.6%和95.2%（患者分析），56.9%和98.0%（血管分析）。与MPI相比，18F-FDG显像在患者水平上有更高的敏感性（80.6%vs64.5%，P = 0.06）。结合18F-FDG分布模式的分类，空腹双时间点18F-FDG显像是诊断冠心病的有效方法。
Background:Myocardial18F-deoxyglucose (18F-FDG) uptake has been observed to be enhanced in patients with coronary artery disease (CAD) under fasting conditions. However, whether the increased18F-FDG is induced by myocardial ischemia and how to discriminate ischemic from physiological18F-FDG uptake have rarely been investigated.Methods:Under fasting conditions,18F-FDG PET imaging was performed in 52 patients with suspected CAD. Two18F-FDG imaging sessions were conducted within two hours after a single administration of18F-FDG (dual-time-point imaging), and with an intervention of an exercise test after the first imaging. Abnormal18F-FDG uptake was determined by the classification of the18F-FDG distribution pattern, and the changes of the18F-FDG distribution between the two PET imaging sessions were analyzed.99mTc-sestamibi was injected at peak exercise and myocardial perfusion imaging (MPI) was conducted after18F-FDG imaging. Coronary angiography was considered the reference for diagnosing CAD.Results:Overall, 54.8% (17/31) of CAD patients and 36.2% (21/58) of stenotic coronaries showed exercise-induced abnormal uptake of18F-FDG. Based on the classification of the18F-FDG distribution pattern, the sensitivity and specificity of exercise18F-FDG imaging to diagnose CAD was 80.6% and 95.2% by patient analysis, 56.9% and 98.0% by vascular analysis, respectively. Compared with MPI,18F-FDG imaging had a tendency to have higher sensitivity (80.6% vs 64.5%, P = 0.06) on the patient level.Conclusion:Myocardial ischemia can induce18F-FDG uptake. With the classification of the18F-FDG distribution pattern, dual-time-point18F-FDG imaging under fasting conditions is efficient in diagnosing CAD.