Federal Fluminense University, Av. Marquês do Paraná, 303 - Centro, Niterói, RJ, 24033-900, Brazil.
National Institute of Cardiology, Rio de Janeiro, Brazil.
J Nucl Cardiol. 2020 Feb;27(1):173-181. doi: 10.1007/s12350-018-1309-5. Epub 2018 Jun 14.
18F-fluorodeoxyglucose (FDG) has been useful in the evaluation of myocardial inflammatory processes. However, it is challenging to identify them due to physiological 18F-FDG uptake. There are no publications demonstrating the application of FDG in post-transplant rejection in humans yet. The aim of this study is to determine the feasibility of suppression of myocardial FDG uptake in post-transplant patients, comparing three different protocols of preparation.
Ten patients after heart transplantation were imaged by FDG associated with three endomyocardial biopsies (EMB), scheduled in the first year after the procedure. Before each imaging, patients were randomized to one of three preparations: (1) hyperlipidic-hypoglycemic diet; (2) fasting longer than 12 hours; and (3) fasting associated with intravenous heparin. All patients would undergo the three methods. FDG images were analyzed using visual analysis scores and relative radiotracer cardiac uptake (RRCU).
The suppression rate of radiotracer activity ranged from 55% to 62%. Visual analysis showed that preparation 3 presented less efficacy in the suppression compared to the others. However, RRCU did not show difference between the preparations.
Suppression of physiological myocardial FDG uptake after cardiac transplantation is feasible. The usefulness of heparin in the suppression is unclear.
18F-氟代脱氧葡萄糖（FDG）在评估心肌炎症过程中非常有用。然而，由于生理摄取 FDG，识别它们具有挑战性。目前尚无文献证明 FDG 在人类移植后排斥反应中的应用。本研究旨在确定在移植后患者中抑制心肌 FDG 摄取的可行性，比较三种不同的准备方案。
10 例心脏移植后患者在术后 1 年内通过 FDG 结合三次心内膜心肌活检（EMB）进行成像。在每次成像之前，患者被随机分配到三种准备方案之一：（1）高脂低糖饮食；（2）禁食超过 12 小时；（3）禁食联合静脉肝素。所有患者都将接受这三种方法。使用视觉分析评分和相对放射性示踪剂心脏摄取（RRCU）分析 FDG 图像。
示踪剂活性的抑制率范围为 55%至 62%。视觉分析显示，与其他两种方案相比，方案 3 的抑制效果较差。然而，RRCU 并没有显示出准备方案之间的差异。
心脏移植后抑制生理性心肌 FDG 摄取是可行的。肝素在抑制中的作用尚不清楚。
