Department of Radiology, General Hospital of Ioannina, 'G. Hatzikosta', Ioannina, Greece.
Nuclear Medicine Laboratory, University of Thessaly, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
Ann Nucl Med. 2020 May;34(5):305-313. doi: 10.1007/s12149-020-01458-7. Epub 2020 Mar 20.
Most of the acute ischemic events, such as acute coronary syndromes and stroke, are attributed to vulnerable plaques. These lesions have common histological and pathophysiological features, including inflammatory cell infiltration, neo-angiogenesis, remodelling, haemorrhage predisposition, thin fibrous cap, large lipid core, and micro-calcifications. Early detection of the presence of a plaque prone to rupture could be life-saving for the patient; however, vulnerable plaques usually cause non-haemodynamically significant stenosis, and anatomical imaging techniques often underestimate, or may not even detect, these lesions. Although ultrasound techniques are currently considered as the "first-line" examinations for the diagnostic investigation and treatment monitoring in patients with atherosclerotic plaques, positron emission tomography (PET) imaging could open new horizons in the assessment of atherosclerosis, given its ability to visualize metabolic processes and provide molecular-functional evidence regarding vulnerable plaques. Moreover, modern hybrid imaging techniques, combining PET with computed tomography or magnetic resonance imaging, can evaluate simultaneously both functional and morphological parameters of the atherosclerotic plaques, and are expected to significantly expand their clinical role in the future. This review summarizes current research on the PET imaging of the vulnerable atherosclerotic plaques, outlining current and potential applications in the clinical setting.
大多数急性缺血事件，如急性冠脉综合征和中风，都归因于易损斑块。这些病变具有共同的组织病理学和病理生理学特征，包括炎症细胞浸润、新生血管形成、重构、出血倾向、薄纤维帽、大脂质核和微钙化。早期发现易破裂的斑块对于患者来说可能是救命的；然而，易损斑块通常导致非血流动力学意义上的狭窄，解剖影像学技术常常低估甚至可能检测不到这些病变。尽管超声技术目前被认为是动脉粥样硬化斑块诊断研究和治疗监测的“一线”检查方法，但正电子发射断层扫描（PET）成像在评估动脉粥样硬化方面可能开辟新的视野，因为它能够可视化代谢过程，并提供有关易损斑块的分子功能证据。此外，结合 PET 与计算机断层扫描或磁共振成像的现代混合成像技术可以同时评估动脉粥样硬化斑块的功能和形态参数，预计在未来将显著扩大其在临床中的作用。这篇综述总结了易损动脉粥样硬化斑块的 PET 成像的当前研究，概述了其在临床环境中的当前和潜在应用。
