(18)^F-FDG及(18)^F-NaF正电子发射断层扫描在颈动脉粥样硬化斑块成像中的研究进展

Progress of(18)^F-FDG and(18)^F-NaF positron emission tomography in carotid atherosclerotic plaque imaging

卒中和脑内其他血栓栓塞事件通常是由于颈动脉粥样硬化所致,其中有炎症存在的动脉粥样硬化斑块更加脆弱,会增加临床症状出现的几率。动脉粥样硬化斑块的发生和发展涉及多种病理生理过程,包括炎症、细胞凋亡、坏死和钙化。正电子发射断层扫描(PET)不仅可以检测而且可以量化动脉粥样硬化形成的病理生理过程。在PET检查的基础上,(18)^F-FDG在颈动脉粥样硬化中显示炎症过程有无可替代的作用,其是一种公认的评估动脉粥样硬化炎症的工具。同时,血管钙化过程在动脉粥样硬化斑块形成的早期阶段发挥重要作用,(18)^F-NaF通过化学吸附沉积在羟基磷灰石上,据此可推断出动脉粥样硬化斑块内是否存在羟基磷灰石,进一步细化炎症过程中钙化的形成过程。本文基于(18)^F-FDG和(18)^F-NaF在PET/CT和PET/MRI上的不同的成像原理,阐述两种显像剂对与颈动脉斑块的最新进展情况。

Stroke and other thromboembolic events in the brain are usually due to carotid atherosclerosis,in which atherosclerotic plaques present with inflammation are more fragile and increase the chance of clinical symptoms.The development and progression of atherosclerotic plaques involves a variety of pathophysiological processes,including inflammation,apoptosis,necrosis,and calcification.PET can not only detect but also quantify the pathophysiological process of atherogenesis.On the basis of PET examination,(18)^F-FDG has an irreplaceable role in demonstrating the inflammatory process in carotid atherosclerosis,and it is a well-established tool for assessing atherosclerotic inflammation.At the same time,the process of vascular calcification plays an important role in the early stage of atherosclerotic plaque formation,and(18)^F-NaF is deposited on hydroxyapatite by chemisorption,based on which the presence of hydroxyapatite in atherosclerotic plaques can be deduced to further refine the formation process of calcification during inflammation.In this paper,based on the different imaging principles of(18)^F-FDG and(18)^F-NaF on PET/CT and PET/MRI,the latest progress of the two imaging agents on carotid plaques is described.