PET心肌灌注显像测定心肌血流量及冠状动脉血流储备的研究进展

Progress of myocardial blood flow and coronary flow reserve measurement using PET myocardial perfusion imaging

PET心肌灌注显像可绝对定量测定局部心肌血流量（MBF）和冠状动脉血流储备（CFR）。由于显像剂半衰期短，允许在短时间内重复进行PET心肌灌注显像，获得静息态、冷加压试验和药物负荷试验等不同状态下的MBF，进而评价冠状动脉血管内皮依赖性和非依赖性的CFR功能。在早期诊断冠心病，准确诊断冠状动脉多支病变，评价微血管病变，早期检测冠状动脉内皮细胞功能异常及CFR功能的异常，估测预后，帮助临床治疗方案的制定以及检测疗效等方面，PET心肌灌注显像有重要的临床价值。该文将介绍PET心肌灌注显像相关知识及其在心血管领域的主要应用。

PET myocardial perfusion imaging permits the measurement of regional myocardial blood flow （MBF） and coronary flow reserve （CFR） in absolute units. The short physical half-life of the flow radiotracers used for these measurements allows repeatedly operating PET myocardial perfusion imaging during the same study session and thus, assessment of MBF at baseline, during cold pressor testing and pharmacologic vasodilation, which contributes to a comprehensive assessment of the endothelium-dependent and endothelium-independent CFR function. Therefore, such measurements of MBF could serve as an important tool to detect early stages of the development of coronary artery disease, multi-vessel coronary artery disease and microvascular disease, indicate an impairment of endothelium-dependent coronary circulatory function, provide predictive information for future cardiovascular events, and contribute to the clinical treatment programs development and therapeutic efficiency testing. The primary technical aspects and clinical applications of PET myocardial perfusion imaging are introduced in this paper.