2011-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/645636摘要：影像檢查不斷進步，但患者往往須要接受多種不同的檢查以求得完整評估，因此，心血管影像的整合研究不僅可以提升臨床診斷的正確性、對於後續處置及有效應用醫療資源也很重要。本研究由功能性影像切入，建立國人的常模 (包括單光子心肌灌注掃描，13N-NH3心肌灌注正子掃描，腦部正子掃描及功能性磁振造影等)，比較不同檢查工具間的臨床應用價值，分析解剖、功能、代謝、灌流等各種影像變化的關聯性，並評估臨床應用價值，對於預測心血管疾病的預後及治療反應的追蹤評估等，多角度切入並長期追蹤。本研究特別關注心臟疾患中的冠心症、心臟衰竭及心臟移植這三大族群，利用長期追蹤，分析多種影像及生物性指標的意義及變化，並了解各種檢查與心血管疾病的診斷、治療、心臟功能及症狀變化，患者生活品質及中長期的存活資料的關聯性，了解其臨床意義，以期建立新的診斷治療及預後指標。本研究分成四部分：1. 單光子心肌灌注掃描：分析國內單光子心肌灌注掃描的臨床應用，建立國人單光子心肌灌注掃常模，建立本土單光子心肌灌注掃描的長期心血管預後價值。2. 心臟移植後冠狀血管病變研究：利用動態性13N-NH3心肌灌注正子掃描了解植體冠狀血管病變的進程，分析預後價值，期能取代侵襲性血管內超音波使用。3. 心臟衰竭多重影像整合研究：建立心臟衰竭長期追蹤族群，分析各種影像檢查與血液生物性指標與心臟衰竭的病程之關聯性及預後價值。4. 腦部功能性影像整合研究：建立腦部磁振造影與氟-18氟化去氧葡萄糖正子攝影檢查(18F-FDG PET) 自動定性定量分析模式，建立國人常模，分析在心血管疾患的臨床應用價值。<br> Abstract: Recent advances of non-invasive cardiovascular imaging modalities, such as echocardiography, nuclear, computed tomography (CT), and magnetic resonance imaging (MRI), can provide invaluable insight into different aspects of the disease process. The integration of information from different imaging modality is of importance not only for clinical diagnosis , therapeutic strategies and outcome prediction, also for better elucidating the underlying pathophysiologic mechanisms.The study is designed to explore the roles of multimodality imaging in cardiovascular diseases. The aims are to establish the norms of database, to compare the diagnosis accuracy, prognostic implications, and to outline an algorithm of use of these non-invasive imaging modalities. In addition, we will correlate with circulating biomarkers and late clinical outcomes to illustrate the roles of multimodality cardiovascular imaging. We will focus on the in coronary diseases, congestive heart failure and post-transplant vasculopathy, including:1. To study the clinical implication of our population-specific norms of myocardial perfusion on single photon emission tomography (SPECT), diagnostic and prognostic values of abnormalities on SPECT, the impact of CT attenuation correction, and the clinical significance of abdominal fat, circulating biomarkers in the risk stratifications of coronary artery disease and late cardiovascular outcomes.2. To study the dynamic 13N-NH3 myocardial positron emission tomography (PET) in post-transplant vasculopathy in the early disease detection, monitoring disease progression and late graft prognosis. We will correlate the dynamic 13N-NH3 PET, intravascular ultrasound (IVUS) and clinical outcomes, and evaluate the feasibility of PET as the first-line surveillance tool.3. To evaluate the relationship and clinical impacts of various non-invasive imaging modalities, biomarkers and clinical parameters in left ventricular dysfunction cohort.4. To establish the automatic analysis platforms of functional brain imaging (perfusion MRI and 18F-FDG PET), to develop the norm and to assess clinical implications in subjects with cardiovascular disease.心肌灌注掃描心臟移植心臟衰竭多重影像整合myocardial perfusion imagingheart transplantationheart failuremultimodality imaging