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绘制新冠病毒病的功能性后遗症:核医学视角

Mapping COVID-19 functional sequelae: the perspective of nuclear medicine.

作者信息

Brandão Simone Cristina Soares, Ramos Júlia de Oliveira Xavier, de Arruda Gustavo Freitas Alves, Godoi Emmanuelle Tenório Albuquerque Madruga, Carreira Lara Cristiane Terra Ferreira, Lopes Rafael Willain, Grossman Gabriel Blacher, de Souza Leão Lima Ronaldo

机构信息

Department of Internal Medicine, Divisions of Cardiology and Nuclear Imaging, Hospital das Clínicas, Federal University of Pernambuco (UFPE) Recife, PE, Brazil.

Recife Medical School, Federal University of Pernambuco (UFPE) Recife, PE, Brazil.

出版信息

Am J Nucl Med Mol Imaging. 2020 Dec 15;10(6):319-333. eCollection 2020.

Abstract

Severe acute respiratory syndrome coronavirus 2 infection is capable of affecting several organs. Direct viral toxicity, pro-inflammatory and pro-thrombotic induction, endothelial damage, immune imbalance, and dysregulation of the renin-angiotensin-aldosterone system are the mechanisms underlying the viral potential of multiple organ damage. The impairment of four organs stands out among severe patients: lung, heart, kidney, and endothelium. The nuclear medicine field holds accurate and safe exam techniques, such as positron emission tomography-computed tomography and scintigraphy, that allow the anatomophysiological study of the majority of human organ systems. By choosing the most appropriate method and radiopharmaceutical, analyzing the presence of inflammation, fibrosis, changes in perfusion, and function of desired organs is possible. Therefore, its use in the monitoring of patients with coronavirus disease 2019 becomes relevant, especially for monitoring sequelae. In this review, we discuss the use of Nuclear Medicine in the detection, monitoring, and therapeutic evaluation of pulmonary and extrapulmonary sequelae by coronavirus disease 2019.

摘要

严重急性呼吸综合征冠状病毒2感染能够影响多个器官。直接病毒毒性、促炎和促血栓形成诱导、内皮损伤、免疫失衡以及肾素-血管紧张素-醛固酮系统失调是多器官损伤病毒潜在作用的潜在机制。在重症患者中,四个器官的损伤较为突出:肺、心脏、肾脏和内皮。核医学领域拥有准确且安全的检查技术,如正电子发射断层扫描-计算机断层扫描和闪烁扫描,这些技术能够对大多数人体器官系统进行解剖生理学研究。通过选择最合适的方法和放射性药物,可以分析炎症、纤维化的存在、灌注变化以及所需器官的功能。因此,其在2019冠状病毒病患者监测中的应用变得至关重要,尤其是对于后遗症的监测。在本综述中,我们讨论核医学在2019冠状病毒病肺部和肺外后遗症的检测、监测及治疗评估中的应用。

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