Chow Benjamin J W, Veinot John P
Department of Laboratory Medicine, Room 123, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada.
Curr Cardiol Rep. 2006 Nov;8(6):439-45. doi: 10.1007/s11886-006-0102-2.
Cardiovascular disease is the leading cause of mortality and morbidity in developed countries. Evidence challenges the notion that the severity of lesions on angiography is a predictor of future cardiac events. With the recognition that subclinical coronary artery stenoses are responsible for myocardial infarcts and sudden death, it may be important to identify patients with plaque characteristics that may place them at increased risk. Intravascular ultrasound, though invasive, remains the current imaging gold standard. Computed tomography, cardiac magnetic resonance, and single-photon emission CT positron emission tomography are evolving and promising modalities. Functional studies reflecting plaque temperature and molecular imaging reflecting plaque constituents are being developed. We review the pathology of the vulnerable atherosclerotic plaque and recent innovations in imaging modalities to assess plaque complication risk.
心血管疾病是发达国家死亡率和发病率的主要原因。有证据对血管造影病变严重程度是未来心脏事件预测指标这一观念提出了挑战。随着认识到亚临床冠状动脉狭窄是心肌梗死和猝死的原因，识别具有可能使其风险增加的斑块特征的患者可能很重要。血管内超声虽然具有侵入性，但仍是目前的成像金标准。计算机断层扫描、心脏磁共振成像和单光子发射计算机断层扫描正电子发射断层扫描是不断发展且有前景的检查方式。反映斑块温度的功能研究和反映斑块成分的分子成像正在研发中。我们综述了易损动脉粥样硬化斑块的病理学以及评估斑块并发症风险的成像方式的最新创新。
