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Medicine

动脉粥样硬化斑块的活动和血管炎症的定量使用[18 F]，氟正电子发射断层扫描/电脑断层扫描（FDG-PET/CT）

Published: May 02, 2012
doi:
10.3791/3777
, , , ,
1Division of Cardiovascular Medicine,University of Pennsylvania, Perelman School of Medicine, 2Department of Radiology,University of Pennsylvania, Perelman School of Medicine, 3Department of Dermatology,University of Pennsylvania, Perelman School of Medicine

Summary

有很大的需要，以确定动脉粥样硬化的非侵入性，在这里，我们演示了如何FDG-PET/CT可用于检测和量化动脉粥样硬化斑块的活动和血管炎症。

Abstract

传统的非侵入性动脉粥样硬化的成像方式，如冠状动脉钙化（CAC）和颈动脉内膜中层厚度（IMT）的2提供有关的疾病负担。然而，尽管3-5成飞，和C-IMT的2,6多个验证研究，这些方式都无法准确评估斑块的特点7,8，和斑块的组成和炎症状态决定了其稳定性，因此，风险9-13临床事件。

[18 F]，2 -氟-2 -脱氧-D-葡萄糖（葡萄糖）利用正电子发射断层扫描（PET）/电脑断层扫描（CT）的影像已被广泛研究在肿瘤学代谢14,15。在人类使用的动物模型和免疫组化的研究表明，FDG-PET/CT是精美的敏感检测巨噬细胞活性，细胞在血管壁炎症的重要来源。莫重新最近，我们17,18和其他人已经表明，FDG-PET/CT使高度精确，在9,16,19,20大型和中型动脉粥样硬化斑块的活动抗炎活性的新型测量。 FDG-PET/CT研究具有比其他成像方式的许多优点：1）高对比度的决议; 2）斑块体积的定量和代谢活性允许多式联运动脉粥样硬化斑块的定量; 3）动态，实时， 体内成像; 4）最小的运营商的依赖。最后，血管炎症FDG-PET/CT检测已被证明预测心血管（CV）事件独立于传统的危险因素，21,22和23动脉粥样硬化的总体负担也高度相关。的牌匾FDG-PET/CT活动调制知名有益的简历干预措施，如短期（12周）他汀类药物治疗24以及长远的治疗性生活方式改变（16月）25。 </P>

目前在动脉粥样硬化斑块的FDG摄取的量化方法涉及测量，以计算目标背景比（TBR的），这是除以计算标准化摄取值（SUV）的利益动脉和静脉血泊由动脉静脉血泊SUV越野车。表明该方法稳定，重复性型代表随着时间的推移，具有灵敏度高，检测血管炎症，也有高间内读者可靠性26。在这里，我们提出我们的方法为患者准备，图像采集，量化使用的SUV，TBR，一个全球性的参数，动脉粥样硬化斑块的活动和血管炎症，称为代谢体积产品（MVP）。这些方法可应用于各种利益一致的方式研究样本，以评估血管炎症，因为我们已经在多个以前的出版物中。9,20,27,28 </ SUP>

Protocol

1。病人的制备及获取图像固定的PET / CT扫描仪至少一个小时的成像时间槽，最好用飞行时间，提高图像质量的能力之一。在我们的机构，我们使用双子座TF扫描仪，这是最新的PET / CT系统，飞利浦医疗系统，并结合在PET扫描仪与华晨16层CT系统对溶菌酶探测器的基础。 有科目快8小时前FDG-PET/CT扫描。检查空腹血清葡萄糖（FSG）的水平，用指尖，以保证血糖<200 mg / dL的葡萄糖管理之前…

Discussion

这里介绍的方法是直接执行，并能产生有用信息，对动脉粥样硬化斑块的活动和血管炎症，在临床上显着的动脉床。这种分析方法有一些值得重视的重要功能：1）我们使用高品质的PET / CT扫描仪，其中有16个探测器行和飞行时间的能力; 2）我们利用两个失明的临床资料，以经验丰富的观察员进行测量，以确保量化数据的一致性; 3）我们同时描述四个量化的成果，这是每一个信息。我们建议至少动?…

Disclosures

The authors have nothing to disclose.

Acknowledgements

NNM支持拨款从国家牛皮癣基金会，的NHLBI 5K23HL97151-3和HL111293。 ，JMG是支持由NHLBI以R01 HL089744和以R01 HL111293。

Materials

Name of the Equipment Company
Gemini TF PET/CT Scanner Philips Healthcare
Extended Brilliance Workstation Philips Healthcare
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References

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Tags

Atherosclerotic Plaque ActivityVascular Inflammation[18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)Non-invasive Imaging ModalitiesCoronary Artery Calcium (CAC)Carotid Intimal Medial Thickness (C-IMT)Plaque CharacteristicsPlaque CompositionInflammatory StateClinical Events[18F]-2-fluoro-2-deoxy-D-glucose (FDG) ImagingPositron-emission Tomography (PET)/computed Tomography (CT)Macrophage ActivityCellular InflammationVessel WallsInflammatory ActivityPlaque VolumeMetabolic ActivityMulti-modal Atherosclerotic Plaque Quantification
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Mehta, N. N., Torigian, D. A., Gelfand, J. M., Saboury, B., Alavi, A. Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT). J. Vis. Exp. (63), e3777, doi:10.3791/3777 (2012).
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