{"title":"心肌灌注成像在急性胸痛治疗中当前作用的关键评估。","authors":"Raffaele Giubbini MD, PhD , Barbara Paghera MD , Maurizio Dondi MD , Enrique Estrada Lobato MD , Amalia Peix MD, PhD , Diana Paez MD","doi":"10.1053/j.semnuclmed.2023.08.003","DOIUrl":null,"url":null,"abstract":"<div><p><span><span>This paper describes the evolution of nuclear cardiology techniques in the setting of </span>acute coronary syndromes<span>. Since the 1970s, the contribution of nuclear cardiology has been fundamental in delineating the physiopathology<span> and diagnosis of acute myocardial infarction, when electrocardiogram (ECG) did not provide the diagnosis and when cardiac enzyme assessments were at a very early stage. In this clinical situation, at that time the role of </span></span></span>pyrophosphate<span><span><span> scintigraphy<span><span><span> and antimyosin antibodies was important in ensuring diagnostic precision. However, these methods showed limitations and were abandoned in the late 80s and early 90s when therapeutic applications such as thrombolytic therapy, and primary-and rescue-percutaneous coronary intervention (PCI) were introduced. Beginning in the mid-80s, the introduction and widespread use of perfusion </span>tracers<span> such as 99mTc labelled compounds and technological advances such as </span></span>SPECT, allowed to assess the efficacy of </span></span>thrombolysis and early </span>revascularization<span>, as well as to assess in depth myocardial salvage. Currently, perfusion SPECT, especially using fast imaging techniques<span> and dedicated cardiac SPECT<span><span> with solid-state detectors, allows a quick confirmation or exclusion of acute coronary syndromes, particularly in low-to-intermediate likelihood of coronary artery disease (CAD), especially when there are absolute or relative contraindications to the use of coronary </span>computed tomographic angiography (CCTA).</span></span></span></span></p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Critical Appraisal of the Current Role of Myocardial Perfusion Imaging in the Management of Acute Chest Pain\",\"authors\":\"Raffaele Giubbini MD, PhD , Barbara Paghera MD , Maurizio Dondi MD , Enrique Estrada Lobato MD , Amalia Peix MD, PhD , Diana Paez MD\",\"doi\":\"10.1053/j.semnuclmed.2023.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p><span><span>This paper describes the evolution of nuclear cardiology techniques in the setting of </span>acute coronary syndromes<span>. Since the 1970s, the contribution of nuclear cardiology has been fundamental in delineating the physiopathology<span> and diagnosis of acute myocardial infarction, when electrocardiogram (ECG) did not provide the diagnosis and when cardiac enzyme assessments were at a very early stage. In this clinical situation, at that time the role of </span></span></span>pyrophosphate<span><span><span> scintigraphy<span><span><span> and antimyosin antibodies was important in ensuring diagnostic precision. However, these methods showed limitations and were abandoned in the late 80s and early 90s when therapeutic applications such as thrombolytic therapy, and primary-and rescue-percutaneous coronary intervention (PCI) were introduced. Beginning in the mid-80s, the introduction and widespread use of perfusion </span>tracers<span> such as 99mTc labelled compounds and technological advances such as </span></span>SPECT, allowed to assess the efficacy of </span></span>thrombolysis and early </span>revascularization<span>, as well as to assess in depth myocardial salvage. Currently, perfusion SPECT, especially using fast imaging techniques<span> and dedicated cardiac SPECT<span><span> with solid-state detectors, allows a quick confirmation or exclusion of acute coronary syndromes, particularly in low-to-intermediate likelihood of coronary artery disease (CAD), especially when there are absolute or relative contraindications to the use of coronary </span>computed tomographic angiography (CCTA).</span></span></span></span></p></div>\",\"PeriodicalId\":21643,\"journal\":{\"name\":\"Seminars in nuclear medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2023-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in nuclear medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0001299823000715\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in nuclear medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0001299823000715","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Critical Appraisal of the Current Role of Myocardial Perfusion Imaging in the Management of Acute Chest Pain
This paper describes the evolution of nuclear cardiology techniques in the setting of acute coronary syndromes. Since the 1970s, the contribution of nuclear cardiology has been fundamental in delineating the physiopathology and diagnosis of acute myocardial infarction, when electrocardiogram (ECG) did not provide the diagnosis and when cardiac enzyme assessments were at a very early stage. In this clinical situation, at that time the role of pyrophosphate scintigraphy and antimyosin antibodies was important in ensuring diagnostic precision. However, these methods showed limitations and were abandoned in the late 80s and early 90s when therapeutic applications such as thrombolytic therapy, and primary-and rescue-percutaneous coronary intervention (PCI) were introduced. Beginning in the mid-80s, the introduction and widespread use of perfusion tracers such as 99mTc labelled compounds and technological advances such as SPECT, allowed to assess the efficacy of thrombolysis and early revascularization, as well as to assess in depth myocardial salvage. Currently, perfusion SPECT, especially using fast imaging techniques and dedicated cardiac SPECT with solid-state detectors, allows a quick confirmation or exclusion of acute coronary syndromes, particularly in low-to-intermediate likelihood of coronary artery disease (CAD), especially when there are absolute or relative contraindications to the use of coronary computed tomographic angiography (CCTA).
期刊介绍:
Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.