Department of Radiology, Harvard Medical School, Boston, MA 02115, USA.
Radiographics. 2011 Sep-Oct;31(5):1239-54. doi: 10.1148/rg.315115056.
Positron emission tomography (PET) is increasingly being applied in the evaluation of myocardial perfusion. Cardiac PET can be performed with an increasing variety of cyclotron- and generator-produced radiotracers. Compared with single photon emission computed tomography, PET offers lower radiation exposure, fewer artifacts, improved spatial resolution, and, most important, improved diagnostic performance. With its capacity to quantify rest-peak stress left ventricular systolic function as well as coronary flow reserve, PET is superior to other methods for the detection of multivessel coronary artery disease and, potentially, for risk stratification. Coronary artery calcium scoring may be included for further risk stratification in patients with normal perfusion imaging findings. Furthermore, PET allows quantification of absolute myocardial perfusion, which also carries substantial prognostic value. Hybrid PET-computed tomography scanners allow functional evaluation of myocardial perfusion combined with anatomic characterization of the epicardial coronary arteries, thereby offering great potential for both diagnosis and management. Additional studies to further validate the prognostic value and cost effectiveness of PET are warranted.
正电子发射断层扫描（PET）越来越多地应用于心肌灌注评估。心脏 PET 可以使用越来越多种回旋加速器和发生器产生的放射性示踪剂进行。与单光子发射计算机断层扫描相比，PET 具有较低的辐射暴露、较少的伪影、改善的空间分辨率，最重要的是，改善的诊断性能。通过定量评估静息-峰值应激左心室收缩功能和冠状动脉血流储备，PET 在检测多支冠状动脉疾病方面优于其他方法，并且可能在危险分层方面具有优势。对于灌注成像正常的患者，可进行冠状动脉钙评分以进一步进行危险分层。此外，PET 还可以定量评估绝对心肌灌注，这也具有重要的预后价值。PET 结合计算机断层扫描的混合扫描仪可以对心肌灌注进行功能评估，并对心外膜冠状动脉进行解剖特征分析，从而为诊断和治疗提供了巨大的潜力。需要进一步的研究来进一步验证 PET 的预后价值和成本效益。
