18F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis
18F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis
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DOI：
10.1007/s00259-017-3639-y
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发表时间：
2017-07-01
影响因子：
9.1
通讯作者：
Picchio, Maria
中科院分区：
文献类型：
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作者：
Incerti, Elena;Tombetti, Enrico;Picchio, Maria
本研究的目的是评估除了当前活动评估提供的信息之外，F-18-氟脱氧葡萄糖 PET/CT (FDG PET/CT) 是否能为高安动脉炎 (TA) 患者提供新的信息，分析可能的混杂因素（例如动脉移植物）的影响，并验证 PET/CT 是否可以为厚度 < 4 mm 的病变提供信息。我们研究了 30 名 TA 患者，评估时间为 2010 年 10 月至 4 月。 2014 年通过 PET/CT 和磁共振成像 (MRI)。所有动脉病变均通过 PET 进行定性（阳性/阴性）和半定量（最大标准化摄取值，SUVmax）评估，并评估 MRI 视野中病变的厚度。在针对每位患者的分析中，评估了 PET 数据与急性期反应物以及 NIH 活性 TA 标准之间的关系。在每个病灶分析中，评估每个病灶的 PET 特征与 MRI 形态学数据之间的关系。还评估了动脉移植物存在的影响。30 名患者中有 16 名 (53%) 以及 177 名血管病变中的 46 名 (26%) 发现 FDG 摄取增加。 7 名接受过血管手术的患者中有 6 名 (86%) 以及 11 名移植物中的 10 名 (91%) 发现假体周围有显着的 FDG 摄取。移植物相关摄取影响了三名患者 (10%) 的 PET 结果和五名患者 (17%) 的 SUVmax 值。在 39 个具有显着 FDG 摄取的病灶中，15 个 (38%) 的厚度 < 4 毫米。仅在富含 FDG 的病变中，病变厚度与病变 SUVmax 相关。 FDG 动脉摄取与全身炎症或 NIH 标准无关。PET/CT 揭示了 TA 动脉受累的独特和基本特征。 PET/CT 可用于评估随访期间独立于全身炎症的局部炎症和血管重塑事件，甚至在动脉壁 < 4 mm 的病变中也是如此。动脉移植物的存在是一个潜在的混杂因素。需要进行前瞻性研究将 PET 结果与相关临床结果关联起来。
The object of this study was to assess whether F-18-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu's arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions < 4 mm thick.We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUVmax), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated.Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUVmax values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were < 4 mm thick. Lesion thickness was correlated with lesion SUVmax in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria.PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is < 4 mm. The presence of arterial grafts is a potential confounder. Prospective studies are required to correlate PET findings with relevant clinical outcomes.