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首页> 外文期刊>The Journal of Nuclear Medicine >Coronary Arterial ^sup 18^F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease
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Coronary Arterial ^sup 18^F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

机译：PET和冠状动脉CT血管造影术在经皮支架置入术治疗急性心肌梗死和稳定型冠状动脉疾病时的冠状动脉sup 18 ^ F-FDG摄取

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Whether ^sup 18^F-FDG PET can detect inflammation in the coronary arteries remains controversial. We examined ^sup 18^F-FDG uptake at the culprit sites of acute myocardial infarction (AMI) after percutaneous coronary stenting (PCS) by coregistering PET and coronary CT angiography (CTA). Methods: Twenty nondiabetic patients with AMI (median age, 62 y; 16 men and 4 women) and 7 nondiabetic patients with stable coronary artery disease (CAD; median age, 67 y; 4 men and 3 women) underwent ^sup 18^F-FDG PET and coronary CTA 1-6 d after PCS of culprit stenoses. After a low-carbohydrate dietary preparation and more than 12 h of fasting, 480 MBq of ^sup 18^F-FDG were injected, and PET images were acquired 3 h later. Helical CTA was performed on a dual-source scanner. Stent position on attenuation-correction noncontrast CT and CTA was used to fuse PET and CTA. Two experienced readers masked to patient data independently quantified maximum target-to-background ratio (maxTBR) at each PCS site. A maxTBR greater than 2.0 was the criterion for significant uptake. Results: Compared with stable CAD patients, more AMI patients exhibited a PCS site maxTBR greater than 2.0 (12/20 vs. 1/7, P = 0.04). More AMI patients were active smokers (9/20 vs. 0/7 in stable CAD, P = 0.03). After adjusting for baseline demographic differences, stent-myocardium distance, and myocardial ^sup 18^F-FDG uptake, presentation of AMI was positively associated with a PCS site maxTBR greater than 2.0 (odds ratio, 31.6; P = 0.044). Prevalence of excess myocardial ^sup 18^F-FDG uptake was similar in both populations (8/20 AMI vs. 3/7 stable CAD, P = 0.89). Conclusion: Systematic fusion of ^sup 18^F-FDG PET and coronary CTA demonstrated increased culprit site ^sup 18^F-FDG uptake more commonly in patients with AMI than in patients with stable CAD. However, this approach failed to detect increased signal at the culprit site in nearly half of AMI patients, highlighting the challenging nature of in vivo coronary artery plaque metabolic imaging. Nonetheless, our findings suggest that imaging of coronary artery inflammation is feasible, and further work evaluating ^sup 18^F-FDG uptake in high-risk coronary plaques prior to rupture would be of great interest. [PUBLICATION ABSTRACT] Show less
机译：18 F-FDG PET能否检测出冠状动脉的炎症仍存在争议。我们通过共配准PET和冠状动脉CT血管造影术（CTA）检查了经皮冠状动脉支架置入术（PCS）后急性心肌梗塞（AMI）罪魁祸首部位的18upF-FDG摄取。方法：对20例AMI的非糖尿病患者（中位年龄62岁； 16名男性和4名女性）和7例患有稳定冠状动脉疾病的非糖尿病患者（CAD；中位年龄为67岁； 4名男性和3名女性）进行^ sup 18 ^ F。 -FDG PET和罪犯狭窄的PCS后1-6 d冠状动脉CTA。在低碳水化合物的饮食准备中，禁食超过12小时后，注入480 MBq的18 ^ F-FDG，3小时后获取PET图像。螺旋CTA在双源扫描仪上进行。衰减校正非对比CT和CTA上的支架位置用于融合PET和CTA。两名对患者数据隐蔽的经验丰富的阅读器独立量化了每个PCS站点的最大靶标与背景之比（maxTBR）。 maxTBR大于2.0是显着摄取的标准。结果：与稳定的CAD患者相比，更多的AMI患者的PCS部位maxTBR大于2.0（12/20与1/7，P = 0.04）。 AMI患者更多是积极吸烟者（稳定CAD中9/20比0/7，P = 0.03）。在调整基线人口统计学差异，支架-心肌距离和心肌吸收18 F-FDG后，AMI的表现与PCS部位maxTBR大于2.0正相关（比值比，31.6； P = 0.044）。两种人群中过量摄取18 ^ F-FDG的患病率相似（8/20 AMI与3/7稳定CAD，P = 0.89）。结论：^ sup 18 ^ F-FDG PET和冠状动脉CTA的系统融合显示，AMI患者的罪魁祸首部位^ sup 18 ^ F-FDG摄取比稳定的CAD患者更常见。然而，这种方法未能在近一半的AMI患者中检测到罪魁祸首部位信号的增加，从而突出了体内冠状动脉斑块代谢成像的挑战性。尽管如此，我们的发现表明，冠状动脉炎症的成像是可行的，对评估高风险冠状动脉斑块破裂前18s-F-FDG摄取的进一步研究将引起人们的极大兴趣。 [出版物摘要]显示较少

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