心肌灌注成像在急性胸痛治疗中当前作用的关键评估。

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Raffaele Giubbini MD, PhD , Barbara Paghera MD , Maurizio Dondi MD , Enrique Estrada Lobato MD , Amalia Peix MD, PhD , Diana Paez MD
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引用次数: 0

摘要

本文介绍了核心脏病学技术在急性冠状动脉综合征中的发展。自20世纪70年代以来,当心电图(ECG)不能提供诊断,并且心脏酶评估处于非常早期的阶段时,核心脏病学在描述急性心肌梗死的物理病理学和诊断方面的贡献是至关重要的。在这种临床情况下,焦磷酸盐闪烁扫描和抗肌球蛋白抗体在确保诊断准确性方面的作用很重要。然而,这些方法显示出局限性,并在80年代末和90年代初被放弃,当时引入了溶栓治疗、原发性和抢救性经皮冠状动脉介入治疗(PCI)等治疗应用。从80年代中期开始,灌注示踪剂(如99mTc标记的化合物)的引入和广泛使用,以及SPECT等技术进步,使其能够评估溶栓和早期血运重建的疗效,以及评估深度心肌挽救。目前,灌注SPECT,特别是使用快速成像技术和具有固态检测器的专用心脏SPECT,允许快速确认或排除急性冠状动脉综合征,特别是在低至中等可能性的冠状动脉疾病(CAD)中,尤其是当冠状动脉计算机断层造影(CCTA)的使用存在绝对或相对禁忌症时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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).

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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
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.
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