Division of Cardiology, Department of Medicine, Michigan State University, East Lansing, MI, USA.
Department of Radiology, Michigan State University, East Lansing, MI, USA.
J Nucl Cardiol. 2018 Apr;25(2):433-440. doi: 10.1007/s12350-017-0826-y. Epub 2017 Feb 21.
PET/CTA was used to evaluate the effect of cholesterol crystal emboli (CCE) on muscle injury. Cholesterol crystals (CCs) released during plaque rupture travel downstream and lodge in muscle triggering inflammation and tissue injury.
Thigh muscles in three groups of rabbits (n = 22) were studied after intra-arterial injection of CCs, Group I (n = 10); polystyrene microspheres, Group II (n = 5); or normal saline, Group III (n = 7). After 48 hours, muscle inflammation and injury were measured by fluorodeoxy-glucose uptake using PET/CTA, serum tissue factor (TF), and creatinine phosphokinase (CPK). Macrophages were stained with RAM11 and CCs with Bodipy.
SUVmax of thigh muscles was greater for Group I vs Group II and III (0.40 ± 0.16 vs 0.21 ± 0.11, P = .038 and 0.23 ± 0.06, P = .036). CPK levels rose significantly in Group I vs Group II and III (6.7 ± 6.0 vs 0.6 ± 0.4, P = .007 and 0.9 ± 0.4 mg·dL, P = .023). No arterial thrombosis was detected by CTA or histology of embolized arteries and TF did not rise significantly. There were extensive macrophage infiltrates surrounding muscle necrosis in Group I only.
Cholesterol crystal emboli triggered muscle inflammation and necrosis with an intact circulation. PET/CTA may help in the early detection of inflammation caused by CCs.
PET/CTA 用于评估胆固醇晶体栓塞（CCE）对肌肉损伤的影响。斑块破裂时释放的胆固醇晶体（CC）顺血流移动并在肌肉中滞留，引发炎症和组织损伤。
三组兔子（n=22）的大腿肌肉在经动脉注射 CC 后进行研究：I 组（n=10）；聚苯乙烯微球，II 组（n=5）；或生理盐水，III 组（n=7）。48 小时后，通过 PET/CTA 测量氟脱氧葡萄糖摄取、血清组织因子（TF）和肌酸磷酸激酶（CPK）评估肌肉炎症和损伤。用 RAM11 染色巨噬细胞，用 Bodipy 染色 CC。
I 组大腿肌肉 SUVmax 高于 II 组和 III 组（0.40±0.16 比 0.21±0.11，P=0.038 和 0.23±0.06，P=0.036）。I 组 CPK 水平显著高于 II 组和 III 组（6.7±6.0 比 0.6±0.4，P=0.007 和 0.9±0.4 mg·dL，P=0.023）。CTA 或栓塞动脉的组织学未检测到动脉血栓形成，TF 也未显著升高。仅 I 组可见大量巨噬细胞浸润伴肌肉坏死。
胆固醇晶体栓塞在循环完整的情况下引发肌肉炎症和坏死。PET/CTA 可能有助于早期检测 CC 引起的炎症。
