De Lorenzo Andrea
Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
Curr Cardiol Rev. 2009 Jan;5(1):52-5. doi: 10.2174/157340309787048112.
The use of cardiac imaging modalities has grown steadily, and cardiac nuclear studies constitute a large part of this number. Nuclear Cardiology is often mistakenly considered a synonym of myocardial perfusion imaging (MPI), but has broader applications, including metabolic imaging, innervation imaging, among other technologies. MPI has been a powerful diagnostic and prognostic tool in the assessment of patients for known or suspected CAD for decades, and is now increasingly used for the evaluation of the anti-ischemic effects of various therapies, according to changes in left ventricular perfusion defect size defined by sequential MPI. Neuronal dysfunction identified with iodine-123-metaiodobenzylguanidine may give information on prognosis in different disease conditions, such as after myocardial infarction, in diabetes and dilated cardiomyopathy. Molecular imaging may identify the predominant cellular population in the atherosclerotic plaque and help predict the likelihood of clinical events. Therefore, although its usefulness is well established, Nuclear Cardiology remains a moving science, whose roles keep in pace with evolving clinical needs and expectations.
心脏成像技术的应用一直在稳步增长，其中心脏核医学检查占了很大一部分。核心脏病学常常被错误地认为是心肌灌注成像（MPI）的同义词，但它有更广泛的应用，包括代谢成像、神经支配成像等技术。几十年来，MPI一直是评估已知或疑似冠心病患者的强大诊断和预后工具，现在根据连续MPI定义的左心室灌注缺损大小的变化，越来越多地用于评估各种治疗的抗缺血效果。用碘-123-间碘苄胍识别出的神经元功能障碍可能为不同疾病状态下的预后提供信息，如心肌梗死后、糖尿病和扩张型心肌病。分子成像可以识别动脉粥样硬化斑块中的主要细胞群，并有助于预测临床事件的可能性。因此，尽管核心脏病学的实用性已得到充分证实，但它仍然是一门不断发展的科学，其作用与不断变化的临床需求和期望同步。
