PET 成像在心脏肉瘤病中的当前用途和理解。

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING American journal of nuclear medicine and molecular imaging Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI:10.62347/NANX3492
Alekhya Madiraju, Abhijit Bhattaru, Truongan Pham, Anish Pundyavana, Krishna Vamsi Rojulpote, William Y Raynor, Thomas J Werner, Abass Alavi
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引用次数: 0

摘要

肉样瘤病是一种病因不明的全身性疾病,其特征是受影响组织中积累非酪氨酸化的免疫性肉芽肿。在心脏肉样瘤病(CS)中,白细胞在心肌内积聚,导致心脏异常。准确和早期诊断 CS 具有挑战性。然而,使用正电子发射断层扫描(PET)成像,即 18F-FDG-PET 已被证明能成功诊断炎症性心肌病。本综述旨在探讨 PET 在治疗心脏肉样瘤病室性心动过速中的作用。正电子发射计算机断层显像(PET)与心脏磁共振成像(CMR)相结合,也被心律失常协会认可为诊断和治疗 CS 相关心律失常的主要方法。CS 诊断后,鉴于可能导致心脏性猝死,必须对室性心律失常进行风险分层。18F-FDG-PET 在监测 CS 患者的疾病进展和治疗反应方面取得了成功。如果出现 VT 的其他征兆,CS 早期患者通常会接受免疫抑制药物治疗。目前,皮质类固醇和抗心律失常化合物:甲氨蝶呤、环磷酰胺、英夫利昔单抗、胺碘酮和硫唑嘌呤被用于抑制炎症。18F-FDG-PET 已被证明是一种非常有用且准确的 CS 诊断工具。CMR 的晚期钆增强可有效检测心肌坏死和/或晚期纤维化瘢痕,而 18F-FDG 则可显示葡萄糖代谢摄取水平的增加。事实证明,PET/MRI 联合扫描能更成功地提高这两种扫描的效果,解决它们的缺点,并突出它们的优点。管理 CS 患者与检测心脏炎症区域密切相关。早期识别可预防心脏异常,主要是 CS 患者的 VT 和 VF,并延长寿命。
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Current uses and understanding of PET imaging in cardiac sarcoidosis.

Sarcoidosis is a systemic disease with unclear etiology characterized by the accumulation of noncaseating, immune granulomas in affected tissues. In cardiac sarcoidosis (CS), white blood cells build up within the heart muscles, causing cardiac abnormalities. Accurate and early diagnosis of CS proves challenging. However, usage of positron emission tomography (PET) imaging, namely 18F-FDG-PET, has proven successful in diagnosing inflammatory cardiomyopathy. This review seeks to examine the role of PET in managing ventricular tachycardia in cardiac sarcoidosis. PET, in conjunction with cardiac magnetic resonance imaging (CMR) is also endorsed as the premier method for diagnosis and management of arrhythmias associated with CS by The Heart Rhythm Society. After a CS diagnosis, risk stratification of ventricular arrhythmias is a necessity given the potential for sudden cardiac death. 18F-FDG-PET has been successful in monitoring disease advancement and treatment responses in CS patients. Early stages of CS are often treated with immunosuppression drugs if there are additional signs of VT. Currently, corticosteroid and anti-arrhythmia compounds: methotrexate, cyclophosphamide, infliximab, amiodarone, and azathioprine are used to suppress inflammation. 18F-FDG-PET has certainly proven to be an incredibly useful and accurate diagnostic tool of CS. While late gadolinium enhancement by CMR is efficient in detecting myocardial necrosis and/or advanced fibrosis scarring, 18F-FDG portrays the increased uptake level of glucose metabolism. In combination PET/MRI has proven to be more successful in improving the efficacy of both scans, addressing their drawbacks, and highlighting their advantages. Managing CS patients is highly involved in detecting inflammatory regions of the heart. Early recognition prevents cardiac abnormality, mainly VT and VF in CS patients, and extends lifespan.

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来源期刊
American journal of nuclear medicine and molecular imaging
American journal of nuclear medicine and molecular imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
4.00%
发文量
4
期刊介绍: The scope of AJNMMI encompasses all areas of molecular imaging, including but not limited to: positron emission tomography (PET), single-photon emission computed tomography (SPECT), molecular magnetic resonance imaging, magnetic resonance spectroscopy, optical bioluminescence, optical fluorescence, targeted ultrasound, photoacoustic imaging, etc. AJNMMI welcomes original and review articles on both clinical investigation and preclinical research. Occasionally, special topic issues, short communications, editorials, and invited perspectives will also be published. Manuscripts, including figures and tables, must be original and not under consideration by another journal.
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