Davies John R, Rudd James H F, Weissberg Peter L, Narula Jagat
Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom.
J Am Coll Cardiol. 2006 Apr 18;47(8 Suppl):C57-68. doi: 10.1016/j.jacc.2005.11.049.
Imaging of atheromatous plaques has traditionally centered on assessing the degree of luminal stenosis. More recently it has become clear that the vulnerable atherosclerotic plaques responsible for the majority of life-threatening syndromes are characterized by high numbers of inflammatory cells and proteins. This has highlighted the urgent need for suitable imaging techniques that can identify and quantify levels of inflammation within atheromatous lesions. Positron emission tomography and single-photon emission computed tomography imaging hold promise in this regard. Tracer compounds capable of assessing macrophage recruitment, foam cell generation, matrix metalloproteinase production, macrophage apoptosis, and macrophage metabolism have been developed and tested in the carotid and peripheral circulation. The identification of inflamed lesions within the coronary circulation, however, remains elusive owing to small plaque size, cardiac and respiratory motion, and lack of a suitable specific nuclear tracer.
传统上，动脉粥样硬化斑块的成像主要集中在评估管腔狭窄程度。最近，人们清楚地认识到，导致大多数危及生命综合征的易损性动脉粥样硬化斑块的特征是存在大量炎症细胞和蛋白质。这凸显了迫切需要合适的成像技术，能够识别并量化动脉粥样硬化病变内的炎症水平。正电子发射断层扫描和单光子发射计算机断层扫描成像在这方面具有前景。能够评估巨噬细胞募集、泡沫细胞生成、基质金属蛋白酶产生、巨噬细胞凋亡以及巨噬细胞代谢的示踪化合物已被研发出来，并在颈动脉和外周循环中进行了测试。然而，由于斑块尺寸小、心脏和呼吸运动以及缺乏合适的特异性核示踪剂，冠状动脉循环中炎症病变的识别仍然困难重重。
