Abstract:Objective This paper investigates the diagnostic value of 18F-fluorodeoxyglucose(FDG) positron emission tomography (PET)/computed tomography(CT) in patients with early active takayasu arteritis (TA). Methods A case-control study was conducted. The clinical data of 10 patients with TA who underwent PET/CT examination in the First Affiliated Hospital of Xi 'an Jiaotong University from January 2020 to December 2022, 2 males and 8 females, aged 20-72 (44.9±17.7) years, were included in the TA group, and 10 age- and gender-matched patients without TA were part of the control group. The 18F-FDG PET/CT imaging results of the two groups were observed, and the vascular lesions were delineated by two experienced radiologists. The maximum standardized uptake value (SUVmax) of the vessel wall was measured in the TA group and the control group, and the differences of the SUVmax between the two groups were compared. Spearman correlation analysis was used to explore the relationship between the SUVmax of the diseased artery wall and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the TA group. Results18F-FDG PET/CT imaging showed mild to moderate increase in glucose metabolism of aorta and its branch vessel walls in the 10 patients with TA. The SUVmax of large arteries in the TA group was 3.38±0.85, which was significantly higher than that in the control group 1.68±0.24 (t=6.12, P<0.001). In the TA group, the SUVmax of large arteries was not correlated with ESR (rs=0.489, P=0.151) but was positively correlated with CRP (rs=0.758, P=0.011), and no correlation existed between ESR and CRP (rs=0.479, P=0.162). Conclusion18F-FDG PET/CT can accurately reflect the extent of TA lesions and the activity of TA through the SUVmax of the vessel wall, which is a reliable imaging method for the diagnosis of early active TA.
刘翔, 尚宇, 刘军, 梁宇霞, 高俊刚, 段小艺, 牛晨. 18F-FDG PET/CT对早期活动性大动脉炎的诊断价值分析[J]. 中华解剖与临床杂志, 2024, 29(1): 24-28.
Liu Xiang, Shang Yu, Liu Jun, Liang Yuxia, Gao Jungang, Duan Xiaoyi, Niu Chen. Analysis of diagnostic value of 18F-FDG PET/CT in early active Takayasu arteritis. Chinese Journal of Anatomy and Clinics, 2024, 29(1): 24-28.
Jiménez D, Soto ME, Martínez-Martínez LA, et al.Assessment of inflammatory activity in Takayasu's arteritis: performance of clinical scores and common biomarkers versus 18F-FDG PET/CT[J]. Clin Exp Rheumatol,2021,39(5):1011-1020. DOI: 10.55563/clinexprheumatol/a71bzh
[2]
Pugh D, Karabayas M, Basu N, et al.Large-vessel vasculitis[J]. Nat Rev Dis Primers, 2022, 7(1): 93.DOI: 10.1038/s41572-021-00327-5
[3]
Weinrich JM, Lenz A, Adam G, et al.Radiologic imaging in large and medium vessel vasculitis[J]. Radiol Clin North Am, 2020,58(4):765-779. DOI: 10.1016/j.rcl.2020.02.001
[4]
O'Connor TE, Carpenter HE, Bidari S, et al. Role of inflammatory markers in Takayasu arteritis disease monitoring[J]. BMC Neurol, 2014,14:62. DOI: 10.1186/1471-2377-14-62
[5]
de Boysson H, Dumont A, Liozon E, et al. Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement[J]. Eur J Nucl Med Mol Imaging, 2017,44(13):2274-2279. DOI: 10.1007/s00259-017-3774-5
[6]
秦茂林, 刘业海, 姚长玉, 等. 正电子发射计算机体层成像-CT与CT增强扫描在下咽癌诊治中的应用价值[J].中华解剖与临床杂志,2016,21(1):6-11. DOI: 10.3760/cma.j.issn.2095-7041.2016.01.002 Qin ML, Liu YH, Yao CY, et al.The application value of positron emission tomography-CT and CT enhanced scan in the diagnosis ;and treatment of hypopharyngeal carcinoma[J].Chin J Anat Clin,2016,21(1):6-11. DOI: 10.3760/cma.j.issn.2095-7041.2016.01.002
[7]
Campochiaro C, Misra DP. PET in Takayasu arteritis: onwards and upwards towards a future of robust multimodality disease activity assessment?[J]. Rheumatology (Oxford), 2022,61(SI):SI4-SI5. DOI: 10.1093/rheumatology/keab644
[8]
Arend WP, Michel BA, Bloch DA, et al.The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis[J]. Arthritis Rheum, 1990,33(8):1129-1134. DOI: 10.1002/art.1780330811
Hellmich B, Agueda A, Monti S, et al.2018 Update of the EULAR recommendations for the management of large vessel vasculitis[J]. Ann Rheum Dis, 2020,79(1):19-30. DOI: 10.1136/annrheumdis-2019-215672
[11]
Gribbons KB, Ponte C, Carette S, et al.Patterns of arterial disease in takayasu arteritis and giant cell arteritis[J]. Arthritis Care Res (Hoboken), 2020,72(11):1615-1624. DOI: 10.1002/acr.24055
[12]
de Souza AW, de Carvalho JF. Diagnostic and classification criteria of Takayasu arteritis[J]. J Autoimmun, 2014,48-49:79-83. DOI: 10.1016/j.jaut.2014.01.012
[13]
孙璐, 任卫东, 张昕彤, 等. 影像学评估活动期大动脉炎研究进展[J].中国介入影像与治疗学,2020,17(5):311-314. DOI: 10.13929/j.issn.1672-8475.2020.05.013 Sun L, Ren WD, Zhang XT, et al.Advances of imaging diagnosis of Takayasu arteritis[J]. Chinese Journal of Interventional Imaging and Therapy,2020,17(5):311-314. DOI: 10.13929/j.issn.1672-8475.2020.05.013
[14]
González-Gay MA, Prieto-Peña D, Martínez-Rodríguez I, et al.Early large vessel systemic vasculitis in adults[J]. Best Pract Res Clin Rheumatol, 2019,33(4):101424. DOI: 10.1016/j.berh.2019.06.006
[15]
Czihal M, Lottspeich C, Hoffmann U.Ultrasound imaging in the diagnosis of large vessel vasculitis[J]. Vasa, 2017,46(4):241-253. DOI: 10.1024/0301-1526/a000625
[16]
Tombetti E, Hysa E, Mason JC, et al.Blood biomarkers for monitoring and prognosis of large vessel vasculitides[J]. Curr Rheumatol Rep, 2021,23(3):17. DOI: 10.1007/s11926-021-00980-5
[17]
van der Geest K, Treglia G, Glaudemans A, et al. Diagnostic value of 18F FDG-PET/CT for treatment monitoring in large vessel vasculitis: a systematic review and meta-analysis[J]. Eur J Nucl Med Mol Imaging, 2021,48(12):3886-3902. DOI: 10.1007/s00259-021-05362-8
[18]
Tezuka D, Haraguchi G, Ishihara T, et al.Role of FDG PET-CT in Takayasu arteritis: sensitive detection of recurrences[J]. JACC Cardiovasc Imaging, 2012,5(4):422-429. DOI: 10.1016/j.jcmg.2012.01.013
Incerti E, Tombetti E, Fallanca F, et al.18F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis[J]. Eur J Nucl Med Mol Imaging, 2017,44(7):1109-1118. DOI: 10.1007/s00259-017-3639-y