18F-NaF PET/MRI for Detection of Carotid Atheroma in Acute Neurovascular Syndrome.

18F-NaF PET/MRI for Detection of Carotid Atheroma in Acute Neurovascular Syndrome.
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18F-NaF PET/MRI 用于检测急性神经血管综合征中的颈动脉粥样硬化。

DOI:
10.1148/radiol.212283
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发表时间:
2022
期刊:
影响因子:
19.7
通讯作者:
Kaczynski J
Kaczynski J
中科院分区:
医学1区
文献类型:
--
作者:
Kaczynski J

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背景MRI与氟18标记氟化钠(18F-NaF) PET可用于识别斑块不稳定性、破裂和 目的评价18F-NaF活性与18F-NaF活性之间的关系, 急性神经血管综合征中的罪犯颈动脉斑块。材料和方法在这项前瞻性观察性队列研究中(2017年10月至2018年1月), 2020),参与者接受18F-NaF PET/MRI。一位经验丰富 临床医生根据症状确定了罪犯颈动脉, 记录审查。18F-NaF摄取定量使用 标准化摄取值和组织与背景的比率。统计 用Welch,χ2, Wilcoxon或Fisher检验。多变量模型用于评估 影像学标记物和罪犯之间的关系 结果共110名参与者进行了评估(平均年龄,68岁± 10岁), 10 [SD]; 70名男性和40名女性)。在110例患者中,34例(32%)既往 脑血管疾病,26例(24%)出现短暂性黑蒙,54例 (49 30例(27%)为脑卒中。相比 非罪犯颈动脉,罪犯颈动脉有更大的狭窄 (≥50%狭窄:30% vs 15% [P= .02]; ≥70%狭窄:25% vs 4.5% [P< .001]) 并且增加了MRI衍生的不良斑块特征的患病率, 包括斑块内出血(42% vs 23%;P= 0.001)。 0.004)、坏死核心(36% vs 18%;P= 0.004)、血栓 (7.3% vs 0%;P= 0.01)、溃疡(18% vs 3.6%;P= 0.001)和较高的18F-NaF摄取 (最大组织背景比,1.38 [IQR,1.12-1.82] vs 1.26[IQR,0.99-1.66];P= .04)。 较高的18F-NaF摄取与 坏死、斑块内出血、溃疡和钙化, 与纤维化呈负相关(P= 0.04至P <0.001)。在多变量分析中, 颈动脉狭窄≥ 70%(比值比,5.72 [95% CI:2.2,18]), MRI衍生的不良斑块特征(比值比,2.16 [95% CI: 1.2,3.9])均与罪犯与非罪犯相关 结论18F标记氟化钠PET/MRI表现特征性, 与研究参与者中的罪犯颈动脉血管相关, 急性神经血管综合征。临床试验注册号NCT 03215550和NCT 03215563 © RSNA,2022
BackgroundMRI and fluorine 18–labeled sodium fluoride (18F-NaF) PET can be used to identify features of plaque instability, rupture, and disease activity, but large studies have not been performed.PurposeTo evaluate the association between18F-NaF activity and culprit carotid plaque in acute neurovascular syndrome.Materials and MethodsIn this prospective observational cohort study (October 2017 to January 2020), participants underwent18F-NaF PET/MRI. An experienced clinician determined the culprit carotid artery based on symptoms and record review.18F-NaF uptake was quantified using standardized uptake values and tissue-to-background ratios. Statistical significance was assessed with the Welch, χ2, Wilcoxon, or Fisher test. Multivariable models were used to evaluate the relationship between the imaging markers and the culprit versus nonculprit vessel.ResultsA total of 110 participants were evaluated (mean age, 68 years ± 10 [SD]; 70 men and 40 women). Of the 110, 34 (32%) had prior cerebrovascular disease, and 26 (24%) presented with amaurosis fugax, 54 (49%) with transient ischemic attack, and 30 (27%) with stroke. Compared with nonculprit carotids, culprit carotids had greater stenoses (≥50% stenosis: 30% vs 15% [P= .02]; ≥70% stenosis: 25% vs 4.5% [P< .001]) and had increased prevalence of MRI-derived adverse plaque features, including intraplaque hemorrhage (42% vs 23%;P= .004), necrotic core (36% vs 18%;P= .004), thrombus (7.3% vs 0%;P= .01), ulceration (18% vs 3.6%;P= .001), and higher18F-NaF uptake (maximum tissue-to-background ratio, 1.38 [IQR, 1.12–1.82] vs 1.26 [IQR, 0.99–1.66], respectively;P= .04). Higher18F-NaF uptake was positively associated with necrosis, intraplaque hemorrhage, ulceration, and calcification and inversely associated with fibrosis (P= .04 toP< .001). In multivariable analysis, carotid stenosis at or over 70% (odds ratio, 5.72 [95% CI: 2.2, 18]) and MRI-derived adverse plaque characteristics (odds ratio, 2.16 [95% CI: 1.2, 3.9]) were both associated with the culprit versus nonculprit carotid vessel.ConclusionFluorine 18–labeled sodium fluoride PET/MRI characteristics were associated with the culprit carotid vessel in study participants with acute neurovascular syndrome.Clinical trial registration no. NCT03215550 and NCT03215563© RSNA, 2022
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影响因子: --
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