颈动脉粥样硬化斑块稳定性评估正电子发射断层扫描/磁共振研究进展

Research progresses in evaluating the stability of carotid atherosclerotic plaque with positron emission tomography/computed tomography

颈动脉粥样硬化斑块破裂是导致脑梗死的主要原因,探索斑块进展的病理生理机制,尽早发现易损斑块是国际研究热点。研究显示炎性反应与斑块发生、发展、破裂密切相关,但炎性反应过程及其与预后关系的病理生理机制尚不清楚。高分辨磁共振成像(high-resolution magnetic resonance imaging,HR-MRI)和正电子发射断层扫描(positron emission tomography,PET)是评价颈动脉粥样硬化斑块的有力手段,HR-MRI能提供斑块形态学信息,PET能提供斑块内炎性反应的巨噬细胞代谢信息。本文重点对HR-MRI、PET及一体化PET/MR成像在颈动脉粥样硬化斑块稳定性评估的研究进展进行综述,阐明颈动脉斑块易损性的病理生理机制,以期进行早期影像学预警,有效预防脑梗死。

Rupture of carotid atherosclerotic plaque is the primary cause of cerebral infarction.It is a cutting edge in atherosclerosis to investigate the pathophysiological mechanism of vulnerable plaque progression for early detection.Recent studies have revealed that inflammation may cause the occurrence,development,and rupture of atherosclerotic plaque,however,its physiological mechanism and relationship with the outcome of atherosclerotic plaque are poorly understood.High-resolution magnetic resonance imaging(HR-MRI)and positron emission tomography(PET)are the non-invasive imaging technology and increasingly applied to evaluate atherosclerotic plaque.As HR-MRI is used for imaging morphology of carotid plaque with high spatial resolution,PET can be used for quantitative imaging macrophages metabolism of response to inflammation with high sensitivity and specificity.In this work,we reviewed the research progresses in the evaluation of carotid atherosclerotic plaque stability with HR-MRI,PET and simultaneous PET/MR imaging to reveal the physiological mechanism of inflammation and plaque stability and provide early imaging warning of vulnerable plaques,and develop more effective treatment strategies.It may play an important role in effectively preventing the occurrence of cerebral infarction.