^(18)F-FDG全身PET/CT 2小时显像探测大动脉炎病灶的价值

Value of ^(18)F-FDG total-body PET/CT 2-hour imaging in detection of Takayasu arteritis

目的探讨^(18)F-FDG全身PET/CT半剂量2 h显像在大动脉炎(TA)活动性病灶探测中的价值。方法回顾性分析2020年1月至2021年6月在复旦大学附属中山医院行全身PET/CT半剂量2 h显像的55例TA患者[男13例、女42例,年龄(34.3±13.9)岁]的临床与影像学资料。TA根据美国风湿病学会(ACR)标准诊断。按照美国国立卫生研究院(NIH)标准将患者分为活动期TA与非活动期TA组。病灶SUVmax≥(肝脏SUVmax-0.1)定义为活动性病灶。同一血管节段有多个病灶者,只选SUVmax最高者。病灶的靶本比为病灶SUVmax/血池SUVmax。使用两独立样本t检验或Mann-WhitneyU检验分析2组间肝脏、血池SUVmax以及病灶靶本比的差异。结果活动期与非活动期TA组分别有39和16例患者,活动性病灶数分别为363和137个。2组肝脏SUVmax分别为1.93±0.45与1.95±0.35,血池SUVmax分别为0.75(0.63,0.98)与0.90(0.77,1.01),差异均无统计学意义(t=0.20,P=0.846;z=-1.45,P=0.148);病灶的靶本比分别为3.09(2.36,4.24)和2.57(2.24,3.25),差异有统计学意义(z=4.05,P<0.001)。结论全身PET/CT半剂量2 h显像在TA患者中有着较好的病灶靶本比,在活动期与非活动期TA患者中均能灵敏地检测到血管壁炎性病灶。

Objective To investigate the value of total-body PET/CT 2 h imaging with half-dose ^(18)F-FDG in the detection of active lesions of Takayasu arteritis(TA).Methods Fifty-five patients with TA(13 males,42 females,age:(34.3±13.9)years),who accepted 2 h total-body ^(18)F-FDG PET/CT scan with half-dose activity in Zhongshan Hospital,Fudan University between January 2020 and June 2021,were retrospectively enrolled.TA was diagnosed according to the American College of Rheumatology(ACR)criteria.Patients were categorized into active TA group and inactive TA group based on the National Institutes of Health(NIH)criteria.Lesions with SUVmax≥(liver SUVmax-0.1)were defined as active lesions.If multiple lesions occurred in one artery segment,only the lesion with the highest SUVmax was chosen.Lesion-to-blood SUVmax ratio was calculated.The independent-sample t test or Mann-Whitney U test was used to analyze the liver SUVmax,blood pool SUVmax and lesion-to-blood ratio between those 2 groups.Results A total of 363 active lesions were found in 39 patients with active TA and 137 lesions were found in 16 patients with inactive TA.The liver SUVmax(1.93±0.45 vs 1.95±0.35;t=0.20,P=0.846)and blood pool SUVmax(0.75(0.63,0.98)vs 0.90(0.77,1.01);z=-1.45,P=0.148)of patients with active and those with inactive TA were not significantly different.The lesion-to-blood ratio in active TA group was higher than that in inactive TA group(3.09(2.36,4.24)vs 2.57(2.24,3.25);z=4.05,P<0.001).Conclusions Total-body PET/CT 2 h imaging has qualified lesion-to-blood ratio in TA imaging.Inflammatory lesions of vascular wall can be detected sensitively in both patients with active TA and those with inactive TA.