Dr. Alessia Gimelli
The availability of different imaging modalities makes it possible to detect several new risk signals from the heart. This is a very important point because there is a need to improve understanding and evaluation of several issues in order to improve diagnosis and prognosis. In particular, nuclear cardiology may have a great added value in the evaluation of inflammation. As a matter of fact, several published studies have demonstrated the possibility to detect inflammatory damage by , due to the fact that 18-F FDG links to macrophages. The use of hybrid imaging with anatomical evaluation obtained by CT makes it possible to detect the exact site of the damaged area. In the future, this could be crucial to guide patient management and therapeutic strategies.
At present, imaging techniques have a determinant role in the evaluation of acute and chronic myocardial infarction. Echocardiography represents the first choice technique due to its wide availability and low cost. The use of speckle tracking can also improve the impact of echocardiography in the evaluation of viability. However, MRI remains the gold standard for the detection of myocardial viability, the quantification of necrotic areas, and the evaluation of myocardial wall thinning. Moreover, MRI is able to evaluate different fibrotic patterns, allowing differential diagnosis.
The possibility to obtain regional and global information about sympathetic innervation may be relevant in patients with arrhythmias, although more prospective studies are warranted.
Finally, in the field of coronary artery disease, fusion imaging can provide new tools for the identification of preclinical cardiac disease, better understanding of disease progression and the evaluation of patient prognosis.
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