Taqueti Viviany R, Dorbala Sharmila
Noninvasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Nucl Cardiol. 2016 Oct;23(5):1008-1015. doi: 10.1007/s12350-016-0603-3. Epub 2016 Aug 3.
Cardiovascular disease continues to be the number one cause of death in women, yet most women are unaware of their risk. Over the last decade, radionuclide myocardial perfusion imaging with positron emission tomography (PET) has become a powerful tool for the diagnosis and risk stratification of patients with known or suspected coronary artery disease (CAD). This editorial viewpoint will review the maturing role of PET imaging in women, particularly as applied to the evaluation of ischemic heart disease. Specifically, we focus on distinct advantages offered by PET imaging in the evaluation of myocardial ischemia in women: (1) improved diagnostic accuracy, including in the presence of breast or adipose tissue and small left ventricular cavity size, (2) decreased radiation exposure through the use of short-lived radiopharmaceuticals, and (3) the ability to quantify myocardial blood flow and coronary flow reserve to diagnose ischemia, even in the absence of obstructive CAD. As such, cardiac PET perfusion imaging stands to play a unique role in defining the diagnosis and prognosis of women with ischemic heart disease, while also guiding new treatment strategies for their more prevalent cardiovascular disease phenotypes.
心血管疾病仍是女性的首要死因，但大多数女性并未意识到自身风险。在过去十年中，正电子发射断层扫描（PET）放射性核素心肌灌注成像已成为诊断和评估已知或疑似冠状动脉疾病（CAD）患者风险分层的有力工具。本社论观点将回顾PET成像在女性中的成熟作用，特别是在评估缺血性心脏病方面的应用。具体而言，我们将重点关注PET成像在评估女性心肌缺血方面的独特优势：（1）提高诊断准确性，包括在存在乳腺或脂肪组织以及左心室腔较小的情况下；（2）通过使用短寿命放射性药物减少辐射暴露；（3）即使在没有阻塞性CAD的情况下，也能够量化心肌血流量和冠状动脉血流储备以诊断缺血。因此，心脏PET灌注成像在确定缺血性心脏病女性的诊断和预后方面可能发挥独特作用，同时也为其更为常见的心血管疾病表型指导新的治疗策略。
