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冠状动脉内高危易损斑块识别的多模态成像进展

杨帆 吴建军

杨帆, 吴建军. 冠状动脉内高危易损斑块识别的多模态成像进展[J]. 分子影像学杂志, 2022, 45(1): 128-133. doi: 10.12122/j.issn.1674-4500.2022.01.26
引用本文: 杨帆, 吴建军. 冠状动脉内高危易损斑块识别的多模态成像进展[J]. 分子影像学杂志, 2022, 45(1): 128-133. doi: 10.12122/j.issn.1674-4500.2022.01.26
YANG Fan, WU Jianjun. Advances in Multimodality Intravascular Imaging for Identification of High-risk Vulnerable Plaques in Coronary Arteries[J]. Journal of Molecular Imaging, 2022, 45(1): 128-133. doi: 10.12122/j.issn.1674-4500.2022.01.26
Citation: YANG Fan, WU Jianjun. Advances in Multimodality Intravascular Imaging for Identification of High-risk Vulnerable Plaques in Coronary Arteries[J]. Journal of Molecular Imaging, 2022, 45(1): 128-133. doi: 10.12122/j.issn.1674-4500.2022.01.26

冠状动脉内高危易损斑块识别的多模态成像进展

doi: 10.12122/j.issn.1674-4500.2022.01.26
基金项目: 国家自然科学基金青年科学基金(81901853);教育部心肌缺血重点实验室开放课题(KF202010);哈尔滨医科大学创新基金(2021)
详细信息
    作者简介:

    杨帆,助理研究员,博士,E-mail: yangfana@sina.com

    通讯作者:

    吴建军,主治医师,博士,E-mail: drwujianjun@sina.com

Advances in Multimodality Intravascular Imaging for Identification of High-risk Vulnerable Plaques in Coronary Arteries

Funds: Supported by Natural Science Foundation for the Youth (NSFY) of China (81901853)
  • 摘要: 冠状动脉粥样硬化斑块破裂或侵蚀引起的血栓形成造成心肌梗死事件的发生。了解斑块是如何从稳定型转变为危及生命的高危易损斑块的过程并寻求有效的早期干预是临床亟需解决的问题。目前,临床中使用的腔内影像学技术可以识别斑块的形态特征,但不能可靠预测哪些稳定型斑块会转变为高危易损斑块发生破裂继发心肌梗死。本文从高危斑块单模态成像进展、血管内分子成像到多模态血管内成像技术的进展作相关整理,并总结近年来多项评估高危易损斑块的研究,对冠脉内高危易损斑块识别的多模态成像在临床转化的可能性和潜力进行综述。

     

  • 表  1  易损斑块特征

    Table  1.   The characteristics of vulnerable plaque

    特征 薄纤维帽斑块 影像学手段
    形态学特征
    钙化 微钙化和钙化结节 CT,OCT IVUS
    成骨细胞钙化 18F-氟化钠摄取
    钙含量 CT, MRI
    管腔细胞 平滑肌细胞迁移 18F-氟乙酰胺摄取
    斑块特征 总斑块负荷 CT,MRI
    正性重构 IVUS,OCT,光谱学,CT
    坏死核心 IVUS,OCT,CT
    生物学特征
    炎症 巨噬细胞聚集 OCT,光谱学,18F-氟脱氧葡萄糖,18F-氟乙酰胺摄取
    血管生成 内皮细胞 18F-氟乙酰胺摄取
    VCAM1 放射性标记抗体
    新生血管 IVUS,OCT
    血流动力学特征 低内皮剪切力 FD-OCT
    OCT: 血管内光学相干断层扫描; IVUS: 血管内超声.
    下载: 导出CSV

    表  2  血管内单模态成像技术特点

    Table  2.   Characteristics of intravascular single-modality intravascular imaging

    声光设备 特点 生物标记成像
    IVUS OCT NIRS NIRF FLIM IVPA
    高分辨率(~10 μm)
    穿透深度(≥5 mm)
    2D脂质成像
    3D脂质成像
    炎症
    胶原弹力层
    NIRS: 近红外光谱; NIRF: 近红外荧光分子成像; FLIM: 荧光寿命成像; IVPA: 血管内光声成像.
    下载: 导出CSV
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  • 收稿日期:  2021-10-14
  • 网络出版日期:  2022-03-29
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