Langer Harald, Gawaz Meinrad
Medizinische Klinik III, Universitätsklinikum Tübingen, Eberhard-Karls-Universitat Tubingen, Otfried-Müller-Str. 10, D-72076 Tubingen, Germany.
Future Cardiol. 2006 Jan;2(1):113-22. doi: 10.2217/14796678.2.1.113.
Despite primary and secondary prevention, serious cardiovascular events such as unstable angina or myocardial infarction still account for a third of all deaths worldwide. Therefore, identifying individual patients with vulnerable plaques at high risk for plaque rupture is a central challenge in clinical medicine. Several noninvasive techniques, such as magnetic resonance imaging, multislice computed tomography and electron beam tomography are currently being tested for their ability to identify such patients by morphological criteria. In contrast, noninvasive scintigraphic techniques use radiolabeled molecules to detect functional aspects in atherosclerotic plaques by visualizing its biologic activity. Based upon knowledge regarding the pathophysiology of atherosclerosis, various studies - in vitro, in vivo and first clinical trials - have used different tracers for plaque imaging studies, including radioactive labeled lipoproteins, components of the coagulation system, cytokines, mediators of the metalloproteinase system, cell adhesion receptors and even whole cells.
尽管有一级和二级预防措施，但不稳定型心绞痛或心肌梗死等严重心血管事件仍占全球所有死亡人数的三分之一。因此，识别具有易损斑块且有斑块破裂高风险的个体患者是临床医学中的一项核心挑战。目前正在测试几种非侵入性技术，如磁共振成像、多层计算机断层扫描和电子束断层扫描，以评估它们通过形态学标准识别此类患者的能力。相比之下，非侵入性闪烁扫描技术使用放射性标记分子，通过可视化动脉粥样硬化斑块的生物活性来检测其功能方面。基于对动脉粥样硬化病理生理学的了解，各种研究——体外、体内和首次临床试验——使用了不同的示踪剂进行斑块成像研究，包括放射性标记的脂蛋白、凝血系统成分、细胞因子、金属蛋白酶系统介质、细胞粘附受体，甚至全细胞。
