非侵入性体内血栓成像在缺血性卒中和短暂性脑缺血发作患者中的应用——简要报告。

Noninvasive In Vivo Thrombus Imaging in Patients With Ischemic Stroke or Transient Ischemic Attack-Brief Report.

机构信息

BHF Centre for Cardiovascular Science (B.W., E.T., R.B., J.A., M.G.M., A.A.S.T., N.L.M., J.N., E.J.R.v.B., M.R.D., M.C.W., D.E.N.), University of Edinburgh, United Kingdom.

Edinburgh Imaging, Queen's Medical Research Institute, United Kingdom (C.L., M.G.M., A.A.S.T., T.C., E.J.R.v.B., M.R.D., M.C.W., D.E.N.).

出版信息

Arterioscler Thromb Vasc Biol. 2023 Sep;43(9):1729-1736. doi: 10.1161/ATVBAHA.122.318204. Epub 2023 Jul 13.

DOI:10.1161/ATVBAHA.122.318204

PMID:37439259

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10443628/

Abstract

BACKGROUND

F-GP1 is a novel positron-emitting radiotracer that is highly specific for activated platelets and thrombus. In a proof-of-concept study, we aimed to determine its potential clinical application in establishing the role and origin of thrombus in ischemic stroke.

METHODS

Eleven patients with recent ischemic stroke (n=9) or transient ischemic attack (n=2) underwent F-GP1 positron emission tomography and computed tomography angiography at a median of 11 (range, 2-21) days from symptom onset. F-GP1 uptake (maximum target-to-background ratio) was assessed in the carotid arteries and brain.

RESULTS

F-GP1 uptake was identified in 10 of 11 patients: 4 in the carotid arteries only, 3 in the brain only, and 3 in both the brain and carotid arteries. In those with carotid uptake, 4 participants had >50% stenosis and 3 had nonstenotic disease. One case had bilateral stenotic disease (>70%), but only the culprit carotid artery demonstrated F-GP1 uptake. The average uptake was higher in the culprit (median maximum target-to-background ratio, 1.55 [interquartile range, 1.26-1.82]) compared with the contralateral nonculprit carotid artery (maximum target-to-background ratio, 1.22 [1.19-1.6]). In those with brain F-GP1 uptake (maximum target-to-background ratio, 6.45 [4.89-7.65]), areas of acute infarction on computed tomography correlated with brain F-GP1 uptake in 6 cases. Ex vivo autoradiography of postmortem infarcted brain tissue showed focal uptake corresponding to intraluminal thrombus within the culprit vessel and downstream microvasculature. There was also evidence of diffuse uptake within some of the infarcted brain tissue reflecting parenchymal petechial hemorrhage.

CONCLUSIONS

F-GP1 positron emission tomography and computed tomography angiography is a novel noninvasive method of identifying in vivo cerebrovascular thrombosis, which holds major promise in understanding the role and origin of thrombosis in stroke.

REGISTRATION

URL: https://www.

CLINICALTRIALS

gov; Unique identifier: NCT03943966.

摘要

背景

F-GP1 是一种新型正电子发射放射性示踪剂，对激活的血小板和血栓具有高度特异性。在一项概念验证研究中，我们旨在确定其在确定缺血性中风中血栓的作用和来源方面的潜在临床应用。

方法

11 名近期发生缺血性中风（n=9）或短暂性脑缺血发作（n=2）的患者在症状发作后中位数为 11 天（范围，2-21 天）时接受 F-GP1 正电子发射断层扫描和计算机断层血管造影。评估颈动脉和大脑中的 F-GP1 摄取（最大靶标-背景比）。

结果

11 名患者中有 10 名发现 F-GP1 摄取：4 名仅在颈动脉，3 名仅在大脑，3 名在大脑和颈动脉均有摄取。在颈动脉摄取的 4 名患者中，有 4 名患者存在>50%狭窄，3 名患者有非狭窄性疾病。1 例为双侧狭窄性疾病（>70%），但仅在罪魁祸首颈动脉中发现 F-GP1 摄取。在罪魁祸首中摄取量更高（中位数最大靶标-背景比，1.55 [四分位距，1.26-1.82]）与对侧非罪魁祸首颈动脉（最大靶标-背景比，1.22 [1.19-1.6]）相比。在大脑中 F-GP1 摄取（最大靶标-背景比，6.45 [4.89-7.65]）的患者中，6 例计算机断层扫描上的急性梗死区域与大脑中 F-GP1 摄取相关。死后梗死脑组织的离体放射自显影显示在罪魁祸首血管内的管腔内和下游微血管内有局灶性摄取，也有证据表明在一些梗死脑组织内有弥漫性摄取，反映出实质内瘀点出血。