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FDG-PET 在心脏感染中的应用。

FDG-PET in cardiac infections.

机构信息

Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy.

出版信息

Semin Nucl Med. 2013 Sep;43(5):377-95. doi: 10.1053/j.semnuclmed.2013.04.003.

Abstract

Cardiac infections include a group of conditions involving the heart muscle, the pericardium, or the endocardial surface of the heart. Infections can extend to prosthetic material or the leads in case of the implantation of devices. Despite their relative low incidence, these conditions that are associated with high morbidity and mortality involve a relevant burden of diagnostic workup. Early diagnosis is crucial for adequate management of patient, as early treatment improves the prognosis; unfortunately, the clinical manifestations are often nonspecific. Accurate and timely diagnosis typically requires the correlation of imaging findings with laboratory data. (18)F-FDG-PET is a well-established imaging modality for the diagnosis and management of malignancies, and evidence is also increasing regarding its value for assessing infectious and inflammatory diseases. This article summarizes published evidence on the usefulness of (18)F-FDG-PET for the diagnosis of cardiac infections, mainly focused on endocarditis and cardiovascular device infections. Nevertheless, the diagnostic potential of (18)F-FDG-PET in patients with pericarditis and myocarditis is also briefly reviewed, considering the most likely future advances and new perspectives that the use of PET/magnetic resonance would open in the diagnosis of such conditions.

摘要

心脏感染包括一组涉及心肌、心包或心脏的心内膜表面的疾病。感染可能会延伸到植入设备的假体材料或导线。尽管这些疾病的发病率相对较低,但与高发病率和死亡率相关的感染会导致诊断工作的负担加重。早期诊断对于患者的充分治疗至关重要,因为早期治疗可改善预后;不幸的是,临床表现通常是非特异性的。准确和及时的诊断通常需要将影像学发现与实验室数据相关联。(18)F-FDG-PET 是一种用于诊断和治疗恶性肿瘤的成熟影像学方法,并且越来越多的证据表明其在评估感染和炎症性疾病方面具有价值。本文总结了关于(18)F-FDG-PET 在心脏感染诊断中的应用的已发表证据,主要集中在心内膜炎和心血管器械感染方面。然而,还简要回顾了(18)F-FDG-PET 在心包炎和心肌炎患者中的诊断潜力,考虑了在这种情况下使用 PET/磁共振可能会带来的未来进展和新视角。

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