Radiolabelled probes for imaging of atherosclerotic plaques.
Radiolabelled probes for imaging of atherosclerotic plaques.
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发表时间：
2012
影响因子：
2.5
通讯作者：
T. Temma;H. Saji
中科院分区：
文献类型：
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作者：
T. Temma;H. Saji
心血管疾病是全世界死亡的主要原因。不稳定的动脉粥样硬化斑块易于破裂，随后血栓形成、血管狭窄和闭塞，并且经常导致急性心肌梗死和脑梗死。因此，不稳定斑块代表了临床环境中的重要诊断目标，并且不稳定斑块的特异性诊断将使得能够对心血管疾病进行预防性治疗。迄今为止，诸如计算机断层扫描（CT）、磁共振成像（MRI）、超声（US）和血管内超声（IVUS）的各种成像方法已经在临床上被广泛使用。尽管这些方法在空间分辨率和对形态学改变（如钙化和血管狭窄）进行详细识别的能力方面具有优势，但这些技术需要技能或专业知识来区分斑块不稳定性，这对于早期诊断和治疗是必不可少的，并且可能存在定量估计的困难。另一方面，核成像技术如正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）可以非侵入性地收集关于功能分子的表达水平和体内代谢活动的定量信息，从而以高灵敏度提供不稳定斑块的功能诊断。具体来说，不稳定斑块的特征是大量的侵入性炎性细胞（巨噬细胞）、增加的氧化应激（其增加在病变中的细胞上表达的氧化LDL及其受体）、增加的巨噬细胞和参与疾病进展的其它细胞的凋亡发生、增加的蛋白酶表达和活性，以及最终由斑块破裂触发的血栓形成，这是导致梗塞发作和缺血性猝死的最重要机制。因此，这些特征都可以成为PET和SPECT分子成像的目标。本文就近年来放射性核素标记的动脉粥样硬化不稳定斑块核成像探针的研究现状和发展趋势作一综述。
Cardiovascular disease is the leading cause of death worldwide. Unstable atherosclerotic plaques are prone to rupture followed by thrombus formation, vessel stenosis, and occlusion and frequently lead to acute myocardial infarction and brain infarction. As such, unstable plaques represent an important diagnostic target in clinical settings and the specific diagnosis of unstable plaques would enable preventive treatments for cardiovascular disease. To date, various imaging methods such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), and intravascular ultrasound (IVUS) have been widely used clinically. Although these methods have advantages in terms of spatial resolution and the ability to make detailed identification of morphological alterations such as calcifications and vessel stenosis, these techniques require skill or expertise to discriminate plaque instability, which is essential for early diagnosis and treatment and can present difficulties for quantitative estimation. On the other hand, nuclear imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) can noninvasively collect quantitative information on the expression levels of functional molecules and metabolic activities in vivo and thus provide functional diagnoses of unstable plaques with high sensitivity. Specifically, unstable plaques are characterized by an abundance of invasive inflammatory cells (macrophages), increased oxidative stress that increases oxidized LDL and its receptor expressed on cells in the lesions, increased occurrence of apoptosis of macrophages and other cells involved in disease progression, increased protease expression and activity, and finally thrombus formation triggered by plaque rupture, which is the most important mechanism leading to the onset of infarctions and ischemic sudden death. Therefore, these characteristics can all be targets for molecular imaging by PET and SPECT. In this paper, we review the present state and future of radiolabelled probes that have been developed for detecting atherosclerotic unstable plaques with nuclear imaging techniques.