Patient with anterior non-ST-segment elevation myocardial infarction with (D) culprit (red arrow left anterior descending artery) and bystander non-culprit (white arrow circumflex artery) lesions on invasive coronary angiography that were both stented during the index admission. Note the significant myocardial uptake overlapping with the coronary artery (yellow arrow) and uptake within the oesophagus (blue arrow). Corresponding 18F-fluorodeoxyglucose PET-CT image (C) showing no uptake at the site of the culprit plaque ( 18F-FDG, tissue-to-background ratios, 1♶3 versus reference segment 1♹1 ). Patient with acute ST-segment elevation myocardial infarction with (A) proximal occlusion (red arrow) of the left anterior descending artery on invasive coronary angiography and (B) intense focal 18F-fluoride ( 18F-NaF, tissue-to-background ratios, culprit 2♲7 versus reference segment 1♰9 ) uptake (yellow-red) at the site of the culprit plaque (red arrow) on the combined positron emission and computed tomogram (PET-CT). 18 (45%) patients with stable angina had plaques with focal 18F-NaF uptake (maximum tissue-to-background ratio 1♹0 ) that were associated with more high-risk features on intravascular ultrasound than those without uptake: positive remodelling (remodelling index 1♱2 vs 1♰1 p=0♰004), microcalcification (73% vs 21%, p=0♰02), and necrotic core (25% vs 18%, p=0♰01). Marked 18F-NaF uptake occurred at the site of all carotid plaque ruptures and was associated with histological evidence of active calcification, macrophage infiltration, apoptosis, and necrosis. By contrast, coronary 18F-FDG uptake was commonly obscured by myocardial uptake and where discernible, there were no differences between culprit and non-culprit plaques (1♷1 vs 1♵8, p=0♳4). In 37 (93%) patients with myocardial infarction, the highest coronary 18F-NaF uptake was seen in the culprit plaque (median maximum tissue-to-background ratio: culprit 1♶6 vs highest non-culprit 1♲4, p<0♰001). The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia. The Lancet Gastroenterology & Hepatology.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |