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Titolo:
Assessment of myocardial perfusion using cardiac positron emission tomography
Autore:
vom Dahl, J;
Indirizzi:
Univ Klinikum, Rhein Westfal TH Aachen, Med Klin 1, D-52057 Aachen, Germany Univ Klinikum Aachen Germany D-52057 Med Klin 1, D-52057 Aachen, Germany
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
fascicolo: 11, volume: 90, anno: 2001,
pagine: 835 - 847
SICI:
0300-5860(200111)90:11<835:AOMPUC>2.0.ZU;2-W
Fonte:
ISI
Lingua:
GER
Soggetto:
CORONARY-ARTERY DISEASE; REGIONAL BLOOD-FLOW; LONG-TERM SMOKING; N-13 AMMONIA; YOUNG MEN; NONINVASIVE QUANTIFICATION; NUCLEAR CARDIOLOGY; OXYGEN-15-LABELED WATER; HEART-TRANSPLANTATION; OXIDATIVE-METABOLISM;
Keywords:
positron emission tomography; heart;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
94
Recensione:
Indirizzi per estratti:
Indirizzo: vom Dahl, J Univ Klinikum, Rhein Westfal TH Aachen, Med Klin 1, Pauwelsstr30, D-52057Aachen, Germany Univ Klinikum Pauwelsstr 30 Aachen Germany D-52057 n, Germany
Citazione:
J. vom Dahl, "Assessment of myocardial perfusion using cardiac positron emission tomography", Z KARDIOL, 90(11), 2001, pp. 835-847

Abstract

Positron emission tomography (PET) of the heart has gained widespread scientific and clinical acceptance with regard to two indications: 1) The detection of perfusion abnormalities by qualitative and semiquantitative analyses of perfusion images at rest and during physical or pharmacological stressusing well-validated perfusion tracers, such as N-13 ammonia, Rb-82 rubidium. chloride, or O-15 labeled water. 2) Viability imaging of myocardial regions with reduced contractility by combining perfusion measurements with substrate metabolism as assessed from F-18 deoxyglucose utilization. This overview summarizes the use of PET as a perfusion imaging method. With a sensitivity > 90% in combination with high specificity, PET is today the best-validated available nuclear imaging technique for the diagnosis of coronary artery disease (CAD). The short half-life of the perfusion tracers in combination with highly sophisticated hard- and software enables rapid PET studies with high patient throughput. The high diagnostic accuracy and the methological advantages as compared to conventional scintigraphy allows one to use PET perfusion imaging to detect subtle changes in the perfusion reserve for the detection of CAD in high risk but asymptomatic patients as well as in patients with proven CAD undergoing various treatment forms suchas risk factor reduction or coronary revascularization. In patients following orthotopic heart transplantation, evolving transplant vasculopathy can be detected at an early stage. Quantitative PET imaging at rest allows for detection of myocardial viability since cellular survival is based on maintenance of a minimal perfusion and structural changes correlate to the degree of perfusion reduction. Furthermore, quantitative assessment of the myocardial perfusion reserve detects the magnitude and competence of collateralsin regions with occluded epicardial collaterals and, thus, imaging of several coronary distribution territories in one noninvasive study. The cost of PET in combination with the cost of a cyclotron facility together with the demanding methological problems have limited the availability of perfusion PET to a few sophisticated centers. Therefore, quantitative PET investigations of myocardial perfusion have been performed predominantly for scientific purposes, and the cost-effectiveness of PET in the everyday clinical setting is not yet finally proven. However, the unique possibilities of PET to study non-invasively and quantitatively myocardial perfusion and metabolism as well as cardiac innervation and pharmacokinetics of cardiac drugs have established cardiac PET as a scientific tool of the highest quality for the future.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 10:41:25