^18氟-氟代脱氧葡萄糖PET／CTA成像无创检测兔动脉粥样硬化易损斑块及血栓  

Noninvasive imaging of vulnerable plaques and thrombuses with PET/CT complex imaging technique

作　　者：赵欣[1] 赵全明[1] 冯婷婷[1] 李德鹏 刘瑜[3] 李丽琴 张明多[1] 庄须翠[1] 赵学成[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科十八病房,北京100029 [2]解放军第二炮兵总医院核医学科 [3]首都医科大学基础医学院病理学系

出　　处：《中华医学杂志》2013年第19期1454-1457,共4页National Medical Journal of China

基　　金：国家自然科学基金（30972810）

摘　　要：目的探讨^18氟-氟代脱氧葡萄糖（^18F—FDG）PET／CTA成像检测兔主动脉易损斑块和预测血栓事件可行性。方法28只雄性新西兰大白兔，高脂饲料饲喂2周后球囊拉伤腹主动脉，继续间断高脂饲养14周后进行药物诱发实验，以期斑块破裂和形成血栓；在药物诱发实验前后分别行主动脉的PET／CTA成像，分段测量主动脉对FDG的摄取情况（SUV值），成像后处死动物获得主动脉段的大体病理和组织学资料。将PET／CTA成像所得数据与组织病理学资料进行统计学分析。结果实验中有8只兔死亡，存活的20只兔中有13只（65％）产生血栓，将有无血栓动脉段在诱发实验前的SUVmean及SUVmax值进行比较，结果未形成血栓动脉段显著低于有血栓形成动脉段（0．77±0．11比1．10±O．19，P=0．000）及（0．80±0．12比1．23±0．29，P=0．000）；将诱发实验后的SUVmean及SUVmax值进行比较，结果未形成血栓动脉段亦显著低于有血栓形成动脉段（0．85±0．17比1．15±0．26，P=0．000）及（0．91±O．19比1．29±0．31，P=0．000）。通过受试者工作特征（ROC）曲线评价SUVmean值对动脉段内血栓形成的预测价值。结果显示ROC曲线下面积为0．898（95％C10．857～0．939），P=0．000，截断值为0．882。结论^18F—FDPPET／CTA这一无创技术可以用于检测易损斑块，并在一定程度上预测斑块破裂和血栓形成的风险。Objective To investigate the feasibility of identifying the vulnerable plaque and predicting plague rupture and thrombus using by positron emission tomography/computed tomography angiography （PET/CTA）. Methods Twenty-eight male New Zealand white rabbits were fed with hyperlipid diet for 2 weeks before the balloon injury of the abdominal aorta. Then these rabbit were intermittendy fed withhyper-lipid diet for 14 weeks, in order to trigger pharmaceuticly the plague iupture and thrombus. PET/CTA scans of abdominal aorta were performed before and after the drug triggering, FDC uptake （ standardized uptake value, SUV） was measured. Rabbits were euthanized to obtain data of pathology and histology. The parameters obtained by PET/CTA, pathology and histology were compared and the eorreclations were performed. Results The thrombosis was identified in 13 of 20 rabbits. Before the drug triggering, 18 F-FDG mean standardized uptake value （SUVmean） washigher in thrombotic arterial segments （defined as vulnerable plaque） （ 1.10 ± 0. 19 vs 0. 77 ± 0. 11, P = 0. 000） ; after the drug triggering, SUVmean was higher in thrombotic arterial segments,too （ 1.15±0. 26 vs 0. 85±0. 17 ,P =0. 000）. We use the ROC curve for SUVmean to predict plaque rupture and thrombosis. The areaunder the curve （AUC） was 0. 898 （P = 0. 000）. The cutoff value was 0. 882. Conclusions Our findings indicated that ^18F-FDG PET/ CTA, as a noninvasive imaging method, could be used toidentify vulnerable plaques and predict thrombosis events.

关 键 词：动脉粥样硬化 正电子发射断层显像术 血管造影术 血栓形成 

分 类 号：R543.5[医药卫生—心血管疾病]