Will 18F-Sodium Fluoride PET-CT Imaging Be the Magic Bullet for Identifying Vulnerable Coronary Atherosclerotic Plaques?
Will 18F-Sodium Fluoride PET-CT Imaging Be the Magic Bullet for Identifying Vulnerable Coronary Atherosclerotic Plaques?
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DOI：
10.1007/s11886-014-0521-4
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发表时间：
2014-09-01
影响因子：
3.7
通讯作者：
Dweck, Marc R.
中科院分区：
文献类型：
--
作者：
Joshi, Nikhil V.;Vesey, Alex;Dweck, Marc R.
心肌梗死仍然是世界范围内过早死亡的最常见原因，冠状动脉粥样硬化斑块破裂通常是导致过早死亡的罪魁祸首。尽管心血管成像技术的应用范围不断扩大，但鉴别动脉粥样硬化损伤的高危破裂——即所谓的易损斑块——的竞赛仍在继续。传统的成像方式，如压力测试和冠状动脉造影一直无法识别这类斑块，这使得人们越来越认识到斑块破裂与管腔狭窄程度以外的其他因素有关。事实上，最近的焦点已经转移到分子成像，试图直接针对导致破裂的病理疾病过程，从而定位高风险病变。组织学数据表明，炎症、坏死和早期微钙化是实现这一目标的关键影像学指标。在这里，我们讨论了这些过程是如何相关的，重点是支持18f -氟化物正电子发射断层扫描作为一种新的非侵入性成像技术来识别易损性动脉粥样硬化斑块的基本原理和证据。
Myocardial infarction remains the commonest cause of premature death worldwide with coronary atherosclerotic plaque rupture often initiating the event. Despite an ever-expanding repertoire of cardiovascular imaging techniques, the race is still on to identify atherosclerotic lesions at high-risk of rupture: the so-called vulnerable plaque. Conventional imaging modalities such as stress testing and coronary angiography have consistently failed to identify such plaques, leading to the increasing appreciation that plaque rupture relates to factors other than just the degree of luminal stenosis. Indeed the focus has recently shifted to molecular imaging, in an attempt to directly target the pathological disease processes leading to rupture and thereby localize high-risk lesions. Histological data indicate that inflammation, necrosis and early stage microcalcification are key imaging targets by which to achieve this aim. Here, we discuss how these processes are related, focusing on the rationale and evidence supporting 18F-fluoride positron emission tomography as a novel non-invasive imaging technique for the identification of vulnerable atherosclerotic plaque.