Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.
Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan.
J Nucl Cardiol. 2021 Oct;28(5):2335-2342. doi: 10.1007/s12350-020-02041-3. Epub 2020 Jan 30.
The present study was performed to compare the relationship of F-fluorodeoxyglucose (FDG) uptake and late gadolinium enhancement (LGE) transmurality with the improvement of left ventricular function in patients with coronary chronic total occlusion (CTO) assessed by hybrid FDG positron emission tomography (PET)/magnetic resonance imaging (MRI).
Thirty-eight consecutive patients with CTO underwent FDG PET/MRI. Twenty-three patients then underwent percutaneous coronary intervention (PCI), and the final study population comprised 15 patients who underwent both initial and follow-up MRI. The degree of wall motion abnormality in each of the 17 myocardial segments was evaluated based on the extent of wall thickening on cine MRI using a 5-point scale.
Among all 646 myocardial segments at baseline, FDG uptake significantly decreased as the transmurality of LGE is advanced. Of the 15 patients who underwent PCI, 152 segments showed wall motion abnormalities at baseline. The functional recovery of the wall motion abnormality of the PET-viable/MRI-viable segments was highest, and that of the PET-nonviable/MRI-nonviable segments was lowest. There were no differences in functional recovery between the PET-viable/MRI-nonviable and PET-nonviable/MRI-viable segments.
Simultaneous assessment of FDG and LGE using a hybrid PET/MRI system can help to predict functional recovery after PCI in patients with CTO.
本研究旨在比较 F-氟脱氧葡萄糖（FDG）摄取与晚期钆增强（LGE）透壁性与通过杂交 FDG 正电子发射断层扫描（PET）/磁共振成像（MRI）评估的冠状动脉慢性完全闭塞（CTO）患者左心室功能改善的关系。
38 例 CTO 患者接受 FDG PET/MRI 检查。23 例患者随后接受经皮冠状动脉介入治疗（PCI），最终研究人群包括 15 例同时进行初始和随访 MRI 的患者。通过电影 MRI 上的壁增厚程度，用 5 分制评估 17 个心肌节段中每个节段的壁运动异常程度。
在基线时的所有 646 个心肌节段中，FDG 摄取随着 LGE 的透壁性进展而显著降低。在接受 PCI 的 15 例患者中，152 个节段在基线时有壁运动异常。PET 存活/MRI 存活节段的壁运动异常的功能恢复最高，而 PET 非存活/MRI 非存活节段的功能恢复最低。PET 存活/MRI 非存活和 PET 非存活/MRI 存活节段之间的功能恢复没有差异。
使用杂交 PET/MRI 系统同时评估 FDG 和 LGE 有助于预测 CTO 患者 PCI 后的功能恢复。
