核素显像剂在心脏淀粉样变性诊断中的应用现状与最新进展  

The Current Application and Latest Developments of RadionuclideImaging Agents in the Diagnosis ofCardiac Amyloidosis

作　　者：钟洪岩 郭娜 张卫方[1] ZHONG Hongyan;GUO Na;ZHANG Weifang(Department of Nuclear Medicine,the 3rd Hospital of Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院核医学科,北京100191

出　　处：《标记免疫分析与临床》2024年第11期2127-2132,共6页Labeled Immunoassays and Clinical Medicine

基　　金：国家重点研发计划(编号:2023YFC3404600)。

摘　　要：淀粉样变性是由多种原因导致的淀粉样物质沉积,心脏受累时造成心脏淀粉样变性(cardiac amyloidosis,CA),甚至心力衰竭。早期诊断及准确分型对于患者的治疗至关重要。核素显像对CA的诊断及分型发挥了重要作用,尤其是^(99)Tc^(m)标记的骨显像剂在心脏转甲状腺素蛋白淀粉样变性诊断方面尤为重要。然而,轻链等类型CA的诊断尚缺乏成熟敏感的显像方法。新型淀粉样特异性放射性示踪剂的开发,尤其是^(18)F标记的PET分子成像显像剂,弥补了骨显像剂的不足,并有助于CA的进一步分型,提高了诊断精确性,并可早期发现、预后评估及疗效监测。本文综述了近年来核素心脏淀粉样变性显像剂应用的现状和进展。尽管有些示踪剂仍处于研究阶段,但其优势显著,预计将在心脏淀粉样变性的诊疗领域发挥重要作用,推动更精准医疗的发展。Amyloidosis is caused by the deposition of amyloid substances due to various reasons,and when the heart is involved,it leads to cardiac amyloidosis(CA),which can even result in heart failure.Early diagnosis and accurate classification are crucial for the treatment of patients with these conditions.Nuclear imaging technique plays an important role in the diagnosis and classification of CA,particularly the use of ^(99)Tc^(m)-labeled bone imaging agents,which is particularly significant in diagnosing cardiac transthyretin amyloidosis.However,there is still a lack of mature and sensitive imaging methods for diagnosing light chain-type CA.The development of new amyloid-specific radiotracers,especially 18 F-labeled PET molecular imaging agents,could address the shortcomings of the current bone imaging agents and aid in further classification of CA.These new agents could improve diagnostic accuracy,enable early detection,prognostic assessment,and therapeutic monitoring.This article reviews the current status and progress of nuclear imaging agents for cardiac amyloidosis in recent years.Although some tracers are still under research stage,their advantages are significant,and they are expected to play an important role in the diagnosis and treatment of cardiac amyloidosis,and further promote the development of more precise medical care.

关 键 词：心脏淀粉样变性 转甲状腺素蛋白淀粉样变性 轻链相关的淀粉样变性 核素显像剂 

分 类 号：R541[医药卫生—心血管疾病]