Aortic wall inflammation due to Takayasu arteritis imaged with 18F-FDG PET coregistered with enhanced CT.
Aortic wall inflammation due to Takayasu arteritis imaged with 18F-FDG PET coregistered with enhanced CT.
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发表时间：
2005-06
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通讯作者：
Yasushi Kobayashi;K. Ishii;K. Oda;T. Nariai;Youji Tanaka;K. Ishiwata;F. Numano
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作者：
Yasushi Kobayashi;K. Ishii;K. Oda;T. Nariai;Youji Tanaka;K. Ishiwata;F. Numano
这项研究的目的是评估(18)F-FDG正电子发射计算机断层扫描(18F-FDGPET)识别大动脉炎、定位和追踪大动脉炎患者疾病活动的能力。评价(18)F-FDGPET与增强CT联合成像在确定血管病变部位和炎症活动性方面的价值。方法根据预先确定的诊断标准诊断大动脉炎。11例活动期大动脉炎患者、3例静止期大动脉炎患者和6例健康体检者行~(18)F-FDG PET增强扫描，以~(18)F-FDG积聚的标准化摄取值(SUV)为指标评价炎性血管病变。对两例活动性疾病患者在治疗过程中进行了18F-FDG PET序列扫描。结果11例大动脉炎活动期患者中，2例18F-FDG PET显示血管内18F-FDG浓聚(SUV>；OR=2.7)。9例活动期患者F-FDG积聚较弱(2.3>；或=SUV>；or=1.2)。非活动期疾病组(SUV<；OR=1.2)和正常对照组(SUV<；1.3)未见明显的F-FDG蓄积。以SUV为1.3作为诊断标准，~(18)F-FDG PET分析诊断大动脉炎的敏感性为90.9%，特异性为88.8%。(18)F-FDG PET和增强CT共同记录了大动脉炎患者的主动脉壁内18F-FDG沉积，这些患者的18F-FDG沉积较弱，而解剖上无法确定。2例活动期患者经治疗后F-FDG积聚消失。~(18)F-FDG积聚消失与全身炎症标志物水平不一致。结论活动性大动脉炎患者的18F-FDG PET图像与增强CT图像相结合，显示了活动性Takayasu大动脉炎患者的主动脉、分支和肺动脉的分布和炎症活动，即使是那些18F-FDG积聚较弱的患者也是如此。治疗后积聚强度降低。
UNLABELLED The purpose of this study was to evaluate the ability of (18)F-FDG PET to identify aortitis and to localize and follow disease activity in patients with Takayasu arteritis. The value of using (18)F-FDG PET coregistered with enhanced CT in determining vascular lesion sites and inflammatory activity was assessed. METHODS Takayasu arteritis was diagnosed according to the predefined criteria. Eleven patients with Takayasu arteritis in the active stage, 3 patients with Takayasu arteritis in the inactive stage, and 6 healthy subjects underwent (18)F-FDG PET coregistered with enhanced CT and the inflammatory vascular lesion was evaluated by using the standardized uptake value (SUV) of (18)F-FDG accumulation as an index. Two patients with active disease were analyzed by sequential (18)F-FDG PET scans during treatment. RESULTS The (18)F-FDG PET revealed intense (18)F-FDG accumulation (SUV > or = 2.7) in the vasculature of 2 of the 11 cases in the active stage of Takayasu arteritis. The other 9 patients in the active stage revealed weak (18)F-FDG accumulation (2.3 > or = SUV > or = 1.2). No significant (18)F-FDG accumulation was observed in the patients with inactive disease (SUV < or = 1.2) and 6 control healthy subjects (SUV < 1.3). Given the cutoff SUV is 1.3, the sensitivity of (18)F-FDG PET analysis of Takayasu arteritis is 90.9% and the specificity is 88.8%. (18)F-FDG PET coregistered with enhanced CT localized (18)F-FDG accumulation in the aortic wall in the patients with Takayasu arteritis who had weak (18)F-FDG accumulation that could not otherwise be identified anatomically. Finally, (18)F-FDG accumulation resolved with therapy in 2 active cases. The disappearance of (18)F-FDG accumulation did not coincide with the level of general inflammatory markers. CONCLUSION The (18)F-FDG PET images coregistered with enhanced CT images showed the distribution and inflammatory activity in the aorta, its branches, and the pulmonary artery in patients with active Takayasu arteritis, even those who had weak (18)F-FDG accumulation. The intensity of accumulation decreased in response to therapy.