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68Ga-Pentixafor PET/CT在原发性醛固酮增多症分型中的临床价值
张娜
谢阳
陈跃
作者及单位信息
·
DOI： 10.3760/cma.j.cn321828-20240314-00099
Clinical value of 68Ga-Pentixafor PET/CT in classification of subtypes of primary aldosteronism
Zhang Na
Xie Yang
Chen Yue
Authors Info & Affiliations
Zhang Na
Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; Institute of Nuclear Medicine, Southwest Medical University, Luzhou 646000, China
Xie Yang
Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; Institute of Nuclear Medicine, Southwest Medical University, Luzhou 646000, China
Chen Yue
Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; Institute of Nuclear Medicine, Southwest Medical University, Luzhou 646000, China
·
DOI： 10.3760/cma.j.cn321828-20240314-00099
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摘要

原发性醛固酮增多症(PA)是继发性高血压最常见的病因，是心血管和代谢性疾病的危险因素之一。其发病率随高血压级别升高而增加。早期诊断及治疗至关重要。PA分型是其诊断过程的重点、难点，与后续治疗决策紧密相关。肾上腺静脉采血(AVS)虽是PA分型诊断的"金标准"，但其为昂贵、操作难度大的侵入性检查，在临床上难以推广。 68Ga-Pentixafor PET/CT属无创影像学检查，能可视化病灶并对病灶进行定位与定性，有助于PA的分型诊断。该文就 68Ga-Pentixafor PET/CT在PA分型诊断中的研究进行综述。

醛固酮增多症;肽类，环;受体，CXCR4;镓放射性同位素;正电子发射断层显像术;体层摄影术，X线计算机;发展趋势
ABSTRACT

Primary aldosteronism (PA) is one of the most common causes of secondary hypertension, and is one of the risk factors of cardiovascular and metabolic diseases. Its incidence increases with the increase of hypertension level. The early diagnosis and treatment of PA are important. The subtype classification of PA is vital but challenging, which is related to the treatment options. Although adrenal vein sampling (AVS) is currently recognized as the gold standard for subtype diagnosis of PA, it′s an invasive test that is technically challenging and expensive, which limits its clinical use. As a non-invasive imaging method, 68Ga-Pentixafor PET/CT can visualize, locate and characterize the lesions, and facilitate PA subtyping. This article reviews the research of 68Ga-Pentixafor PET/CT in the subtype diagnosis of PA.

Hyperaldosteronism;Peptides, cyclic;Receptors, CXCR4;Gallium radioisotopes;Positron-emission tomography;Tomography, X-ray computed;Trends
Chen Yue, Email: mocdef.6ab213255euynehc
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张娜,谢阳,陈跃. 68Ga-Pentixafor PET/CT在原发性醛固酮增多症分型中的临床价值 [J]. 中华核医学与分子影像杂志,2025,45(03)：185-188.

DOI:10.3760/cma.j.cn321828-20240314-00099

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原发性醛固酮增多症(primary aldosteronism, PA)是继发性高血压最常见的病因，其患病率随高血压的级别增高而增加 [ 1 , 2 ]。国内研究提示，在新诊断的高血压患者中，PA患病率至少为4.0%，占所有高血压的5%～10% [ 1 , 3 , 4 ]。与原发性高血压相比，PA可增加发生卒中、冠状动脉疾病、糖尿病及代谢综合征等的风险，是心血管和代谢性疾病的危险因素之一 [ 5 , 6 ]。因此，PA的早期诊断至关重要。
醛固酮瘤(aldosterone-producing adenoma, APA)、特发性醛固酮增多症(idiopathic hyperaldosteronism, IHA)为PA主要亚型，分别占35%和60% [ 7 ]。根据单、双侧又可分为单侧PA(unilateral PA, UPA)和双侧PA(bilateral PA, BPA)。UPA主要采用肾上腺切除术，BPA采用盐皮质激素受体拮抗剂治疗，且手术效果更佳 [ 8 , 9 ]。
分型是PA诊断的重难点。肾上腺静脉采血(adrenal vein sampling, AVS)是PA分型的"金标准" [ 7 , 8 , 10 ]，但临床上推广较难。CT虽是首选影像学检查，但对较小及无功能的病灶易漏诊和误判。研究表明CT对PA分型的准确性仅为50%～70%，与AVS的符合率为50%～75% [ 9 , 11 , 12 ]。MRI的空间分辨率较CT低 [ 8 ]，其对APA的灵敏度与特异性为86.4%和81.8% [ 13 ]。 68Ga-Pentixafor PET/CT以趋化因子CXC亚家族受体4(CXC subfamily receptor 4, CXCR4)为靶点 [ 14 ]，可视化病灶对显像剂的摄取，能对病灶进行定位与定性，从而区分UPA、BPA及判断病灶的功能特点。本文对 68Ga-Pentixafor PET/CT在PA分型中的临床价值予以综述。
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备注信息
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陈跃，Email: mocdef.6ab213255euynehc
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张娜：研究实施、论文撰写；陈跃、谢阳：研究指导、论文修改、经费支持

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泸州市科学技术和人才工作局-核医学创新转化平台 (2021LZXNYD-P03)
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