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Myocardial perfusion imaging: A brief review of nuclear and nonnuclear techniques and comparative evaluation of recent advances

机译:心肌灌注成像:核技术和非核技术的简要回顾以及对近期进展的比较评估

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Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Invasive coronary angiography (ICA) is the gold standard for the evaluation of epicardial CAD. In the pathogenesis of the CAD, myocardial perfusion abnormalities are the first changes that appear followed by wall motion abnormalities, electrocardiogram changes, and angina. Myocardial perfusion imaging (MPI) demonstrates the cumulative effect of pathology at epicardial coronary arteries, small vessels, and endothelium. Thus, it evaluates the overall burden of ischemic heart disease (IHD). MPI is used noninvasively to diagnose early asymptomatic CAD or to know the functional significance of known CAD. There are evidence that early detection of myocardial perfusion abnormalities followed by aggressive intervention against cardiovascular risk factors may restore myocardial perfusion. This may lead to reduce morbidity and mortality. Various MPI modalities have been used to diagnose and define the severity of CAD. Cardiac myocardial perfusion single-photon emission computed tomography (myocardial perfusion scintigraphy [MPS]) has been in use since decades. Several newer modalities such as positron emission tomography, cardiac magnetic resonance imaging, computed tomography perfusion, and myocardial contrast echocardiography are developing utilizing the similar principle of MPS. We shall be reviewing briefly these modalities, their performance, comparison to each other, and with ICA.
机译:冠状动脉疾病(CAD)是全球发病率和死亡率的主要原因。冠状动脉造影(ICA)是评估心外膜CAD的金标准。在CAD的发病机制中,首先出现的心肌灌注异常是壁动异常,心电图变化和心绞痛。心肌灌注成像(MPI)证实了在心外膜冠状动脉,小血管和内皮细胞上病理学的累积作用。因此,它评估了缺血性心脏病(IHD)的总体负担。 MPI被无创地用于诊断早期无症状CAD或了解已知CAD的功能意义。有证据表明,早期发现心肌灌注异常,然后积极干预心血管危险因素,可能会恢复心肌灌注。这可能会降低发病率和死亡率。各种MPI模式已用于诊断和定义CAD的严重性。几十年来,一直在使用心脏心肌灌注单光子发射计算机断层扫描(心肌灌注显像术[MPS])。利用MPS的相似原理,正在开发几种较新的模式,例如正电子发射断层扫描,心脏磁共振成像,计算机断层扫描灌注和心肌对比超声心动图。我们将简要回顾这些模式,它们的性能,彼此之间的比较以及与ICA的比较。

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