Kuwert Torsten, Römer Wolfgang, Hornegger Joachim
Nuklearmedizinische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Herz. 2007 Mar;32(2):122-8. doi: 10.1007/s00059-007-2959-2.
Technical progress has engendered a broad spectrum of methods to image cardiac structure, function, and metabolism. Frequently, the imaging tools available provide complementary information. Therefore, methods to integrate image information from different modalities into one common coordinate system are increasingly receiving attention also in cardiology. Currently available technology includes software-based image fusion as well as hardware-based registration of datasets. The latter capitalizes on so-called hybrid cameras combining detectors of different modalities in one gantry. Hardware-based image fusion is, to date, anatomically more accurate than the software-based methodology. However, the anatomic accuracy of both approaches is still far from perfect. This is, in particular, due to artifacts caused by respiratory movements also affecting the heart. The clinical potential of correlative imaging of the heart includes an improvement of accuracy in diagnosing hemodynamically significant coronary artery disease using single-photon emission computed tomography (SPECT). This is due to the possibility to correct myocardial scintigraphy for attenuation artifacts using registered X-ray computerized tomographic (CT) images. The visualization of coronary anatomy and myocardial perfusion in one imaging session using hybrid systems combining CT with positron emission tomography (PET) or SPECT is also an interesting option. Nevertheless, larger clinical trials investigating its usefulness are still missing. The possibility to match structure with radioactivity concentration is essential for approaches to image the molecular composition of atherosclerotic plaques and their stability.
技术进步催生了一系列用于心脏结构、功能和代谢成像的方法。通常，现有的成像工具可提供互补信息。因此，将来自不同模态的图像信息整合到一个共同坐标系中的方法在心脏病学领域也越来越受到关注。目前可用的技术包括基于软件的图像融合以及基于硬件的数据集配准。后者利用了所谓的混合相机，将不同模态的探测器组合在一个机架中。迄今为止，基于硬件的图像融合在解剖学上比基于软件的方法更准确。然而，这两种方法的解剖学准确性仍远非完美。这尤其归因于呼吸运动引起的伪影也会影响心脏。心脏相关成像的临床潜力包括提高使用单光子发射计算机断层扫描（SPECT）诊断具有血流动力学意义的冠状动脉疾病的准确性。这是因为有可能使用配准的X射线计算机断层扫描（CT）图像校正心肌闪烁显像的衰减伪影。使用结合CT与正电子发射断层扫描（PET）或SPECT的混合系统在一次成像过程中可视化冠状动脉解剖结构和心肌灌注也是一个有趣的选择。然而，仍缺乏研究其效用的大型临床试验。将结构与放射性浓度匹配的可能性对于成像动脉粥样硬化斑块的分子组成及其稳定性的方法至关重要。
