Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Crit Care. 2011 Feb;17(1):7-12. doi: 10.1097/MCC.0b013e32834272ab.
PET has recently gained traction among several groups of investigators as an imaging tool to study lung pathophysiology in vivo noninvasively on a regional basis. This review aims to present the major findings of PET studies on acute lung injury (ALI) and ventilator-induced lung injury (VILI) with a perspective relevant to the physiologist-intensivist.
Using various tracers, PET has been used to investigate the relationship between the distributions of pulmonary perfusion, ventilation and aeration, and the effect of positive end-expiratory pressure, recruitment maneuvers, prone positioning, and endotoxin on these distributions in ALI. More recently, PET with 2-[18F]fluoro-2-deoxy-D-glucose has been used to measure regional neutrophil metabolic activation in ALI and VILI. Because gas exchange impairment and inflammation are two hallmarks of ALI and VILI, these studies have provided significant insights into the pathophysiology of these conditions.
PET is a versatile imaging tool for physiologic investigation. By imaging the regional effects of interventions commonly performed in critically ill patients with ALI, PET has improved our understanding of the mechanism by which such interventions can exert their positive or negative effects as well as of the pathophysiology of ALI and VILI.
正电子发射断层扫描（PET）最近在多个研究小组中得到了重视，成为一种非侵入性、基于区域的活体肺生理学研究的影像学工具。本文旨在从生理学家-重症医师的角度，介绍关于急性肺损伤（ALI）和呼吸机相关性肺损伤（VILI）的 PET 研究的主要发现。
使用各种示踪剂，PET 已被用于研究肺灌注、通气和通气分布之间的关系，以及呼气末正压、复张手法、俯卧位和内毒素对 ALI 中这些分布的影响。最近，使用 2-[18F]氟-2-脱氧-D-葡萄糖的 PET 已被用于测量 ALI 和 VILI 中区域性中性粒细胞代谢激活。由于气体交换障碍和炎症是 ALI 和 VILI 的两个标志，这些研究为理解这些疾病的病理生理学提供了重要的见解。
PET 是一种用于生理研究的多功能成像工具。通过对 ALI 重症患者中常见干预措施的区域效应进行成像，PET 提高了我们对这些干预措施如何发挥积极或消极作用的机制的理解，以及对 ALI 和 VILI 的病理生理学的理解。
