Ngo Vincent, Martineau Patrick, Harel Francois, Pelletier-Galarneau Matthieu
Department of Medical Imaging, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1C1C8, Canada.
BC Cancer, Vancouver, BC, Canada.
Curr Cardiol Rep. 2022 Dec;24(12):1855-1864. doi: 10.1007/s11886-022-01805-2. Epub 2022 Nov 8.
The purpose of this review is to provide an overview of the role of PET MPI in the detection of CAD, focussing on the added value of MBF for diagnosis and prognostication.
Positron emission tomography (PET) myocardial perfusion imaging (MPI) is increasingly used for the risk stratification of patients with suspected or established coronary artery disease (CAD). PET MPI provides accurate and reproducible non-invasive quantification of myocardial blood flow (MBF) at rest and during hyperemia, providing incremental information over conventional myocardial perfusion alone. Inclusion of MBF in PET MPI interpretation improves both its sensitivity and specificity. Moreover, quantitative MBF measurements have repeatedly been shown to offer incremental and independent prognostic information over conventional clinical markers in a broad range of conditions, including in CAD. Quantitative MBF measurement is now an established and powerful tool enabling accurate risk stratification and guiding patients' management. The role of PET MPI and flow quantification in cardiac allograft vasculopathy (CAV), which represents a particular form of CAD, will also be reviewed.
本综述旨在概述正电子发射断层心肌灌注显像（PET MPI）在冠心病（CAD）检测中的作用，重点关注心肌血流（MBF）在诊断和预后评估方面的附加价值。
正电子发射断层显像（PET）心肌灌注成像（MPI）越来越多地用于疑似或确诊冠心病（CAD）患者的危险分层。PET MPI可对静息和充血状态下的心肌血流（MBF）进行准确且可重复的无创定量分析，相较于单纯的传统心肌灌注成像能提供更多信息。在PET MPI解读中纳入MBF可提高其敏感性和特异性。此外，在包括CAD在内的多种情况下，定量MBF测量多次显示出比传统临床指标能提供更多且独立的预后信息。定量MBF测量现已成为一种成熟且强大的工具，能够实现准确的危险分层并指导患者管理。PET MPI和血流定量分析在心脏移植血管病变（CAV）（CAD的一种特殊形式）中的作用也将进行综述。
