Santos Beatriz Saldanha, Ferreira Maria João
Serviço de Cardiologia, Hospital Distrital de Santarém, Santarém, Portugal.
Faculdade de Medicina, Centro Hospitalar e Universitário de Coimbra, Universidade de Coimbra, Coimbra, Portugal.
Rev Port Cardiol (Engl Ed). 2019 Aug;38(8):599-608. doi: 10.1016/j.repc.2019.02.011. Epub 2019 Nov 3.
Non-invasive assessment of ischemic heart disease remains a challenging task, even with a large armory of diagnostic modalities. Positron emission tomography (PET) is an advanced radionuclide technique that has been available for decades. Originally used as a research tool that contributed to advances in the understanding of cardiovascular pathophysiology, it is now becoming established in clinical practice and is increasingly used in the diagnosis and risk stratification of patients with ischemic heart disease. PET myocardial perfusion imaging has a mean sensitivity and specificity of around 90% for the detection of angiographically significant coronary artery disease, and is also highly accurate for assessing the prognosis of patients with ischemic heart disease. Depending on the radiotracer used, it can provide information not only on myocardial perfusion but also on myocardial metabolism, which is essential for viability assessment. The potential of this imaging technique has been further increased with the introduction of hybrid scanners, which combine PET with computed tomography or cardiac magnetic resonance imaging, offering integrated morphological and functional information and hence comprehensive assessment of the effects of atherosclerosis on the myocardium. The scope of this review is to summarize the role of PET in ischemic heart disease.
即使有大量的诊断方法，对缺血性心脏病进行无创评估仍然是一项具有挑战性的任务。正电子发射断层扫描（PET）是一种先进的放射性核素技术，已经应用了几十年。它最初作为一种研究工具，为推动心血管病理生理学的理解做出了贡献，现在正在临床实践中确立地位，并越来越多地用于缺血性心脏病患者的诊断和风险分层。PET心肌灌注成像检测血管造影显示有显著意义的冠状动脉疾病的平均敏感性和特异性约为90%，对于评估缺血性心脏病患者的预后也高度准确。根据所使用的放射性示踪剂，它不仅可以提供心肌灌注信息，还可以提供心肌代谢信息，这对于存活心肌评估至关重要。随着将PET与计算机断层扫描或心脏磁共振成像相结合的混合型扫描仪的引入，这种成像技术的潜力得到了进一步提升，它能提供综合的形态学和功能信息，从而全面评估动脉粥样硬化对心肌的影响。本综述的范围是总结PET在缺血性心脏病中的作用。
