New insight of functional molecular imaging into the atheroma biology: 18F-NaF and 18F-FDG in symptomatic and asymptomatic carotid plaques after recent CVA. Preliminary results
New insight of functional molecular imaging into the atheroma biology: 18F-NaF and 18F-FDG in symptomatic and asymptomatic carotid plaques after recent CVA. Preliminary results
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DOI：
10.1111/cpf.12254
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发表时间：
2016-11-01
影响因子：
1.8
通讯作者：
Carril, J. M.
中科院分区：
文献类型：
--
作者：
Quirce, R.;Martinez-Rodriguez, I.;Carril, J. M.
目的识别易损斑块，为脑血管意外（CVA）的有效治疗提供依据。通过18F-NaF和18F-FDG PET/CT.Methods对9例近期CVA且未接受他汀类药物预防性治疗的患者进行评估，并比较有症状和无症状斑块的颈动脉粥样硬化活动性钙化和炎症。在每例患者中，CT血管造影片均检测到至少一个动脉粥样斑块。总共有18个斑块可用：9个有症状，9个无症状。通过计算靶/本底比值（TBRs）和TBR指数，目视和半定量评估每个斑块的18F-NaF摄取和18F-FDG摄取结果18F-NaF和18F-FDG在2组斑块中均有摄取，18F-NaF和18F-FDG在2组斑块中的摄取率分别为18F-NaF/18F-FDG/18半定量显示18个斑块中有11个斑块的18F-NaF摄取较高，其中6个斑块有症状，5个斑块无症状。在有症状组中，平均18F-NaF TBR为2.12 +/- 0.44，在无症状组中为1.85 +/- 0.46。18F-NaF/18F-FDG显示，总体而言，18F-NaF摄取高于18F-FDG。在有症状的斑块中，18F-NaF在低钙斑块中含量最高，在高钙斑块中含量最低。结论有症状和无症状的颈动脉粥样硬化中，活动性钙化和炎症同时发生。然而，在两组中，活动性钙化似乎都比炎症突出。在有症状的斑块中，最高的18F-NaF摄取并不对应于最大的钙含量。这些模式打开了新的见解18F-NaF在钙化的研究中的作用，并在脆弱的颈动脉粥样硬化的识别。
Aim The identification of the vulnerable atheroma plaque could allow a more effective treatment of cerebrovascular accident (CVA). Active calcification and inflammation of the carotid atheroma were assessed and compared in symptomatic and asymptomatic plaques by 18F-NaF and 18F-FDG PET/CT.Methods Nine patients investigated for recent CVA and no preventive treatment with statins were enrolled. In each patient, at least one atheroma plaque was detected by CT angiogram. In total, 18 plaques were available: 9 symptomatic and 9 asymptomatic. 18F-NaF uptake and 18F-FDG uptake by each plaque were assessed visually and semiquantitatively by calculating target/background ratios (TBRs) and TBR indexes (TBR symptomatic/TBR asymptomatic and 18F-NaF TBR/18F-FDG TBR within each of the 2 clinical groups of plaques).Results All plaques showed 18F-NaF and 18F-FDG uptake, and semiquantitation showed higher 18F-NaF uptake by 11 of the 18 plaques, 6 symptomatic and 5 asymptomatic. In the symptomatic group, the mean 18F-NaF TBR was 2.12 +/- 0.44, and in the asymptomatic group, it was 1.85 +/- 0.46. The 18F-NaF/18F-FDG showed that, overall, 18F-NaF uptake is higher than 18F-FDG. In the symptomatic plaques, the 18F-NaF was higher for the low calcium content and the lowest for the high.Conclusion Active calcification and inflammation are simultaneous processes in the symptomatic and asymptomatic carotid atheroma. However, active calcification seems predominant over inflammation in both groups. In the symptomatic plaques, the highest 18F-NaF uptake does not correspond with the largest calcium content. These patterns open new insights on the role of 18F-NaF in the study of calcification and in the identification of the vulnerable carotid atheroma.