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绝对定量心肌血流(myocardial blood flow,MBF)对阻塞或非阻塞性冠心病(coronary heart disease,CAD)的诊断、危险分层和预后评估具有重要的临床增益价值。近年来,PET心肌灌注显像(myocardial perfusion imaging,MPI)因具有较高的图像质量、诊断准确率及较广的设备普及性而日益受到临床重视[1]。PET可以更精确地对体内显像剂的放射性浓度进行定量,从而实现无创、准确的MBF绝对定量[2-3],其被认为是无创性绝对定量MBF的“金标准”。通常情况下,15O-H2O是最理想的绝对定量MBF的显像剂,但其不能获得静态图像;而13N-NH3·H2O不仅能够准确地绝对定量MBF,还可以获得高质量的静态图像。然而,两者都需要通过回旋加速器现场制备,这使得它们未被广泛应用。82Rb虽然可以通过发生器现场制备,但其心肌首过摄取率低、正电子射程大且静态图像质量相对较低[4]。鉴于18F具有良好的物理性质和显像质量,对PET MPI显像剂的研究热点转向了18F标记的化合物。18F具有适合的物理半衰期(109.8 min)、较短的正电子射程(约1 mm)和较低的注射剂量,克服了既往经典PET MPI显像剂的固有缺点[5]。其中,2-叔丁基-氯-5[4-(2-氟-18F-乙氧基甲基)苯基甲氧基]-3(2H)-哒嗪酮(2-tert-butylchloro-5[4-(2-fluoro-18F-ethoxymethyl)phenyl methoxy]-3(2H)-pyridazine ketone,18F-Flurpiridaz)几乎满足了所有主要的理想特性:心肌摄取率高、正电子射程短、物理半衰期合适、T/NT高,且便于远程配送。其可与线粒体内膜电子传递链的线粒体复合物Ⅰ结合,并具有较高的亲和力。18F-Flurpiridaz的动物实验结果表明,其具有良好的图像质量和较高的对比度[6-7],且其第Ⅰ、Ⅱ和Ⅲ期临床研究已经完成[8-10]。我们就18F-Furpiridaz PET绝对定量MBF显像的研究进展进行综述。
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