^(18)F-FDG PET/CT对早期活动性大动脉炎的诊断价值分析

Analysis of diagnostic value of^(18)F-FDG PET/CT in early active Takayasu arteritis

目的探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射体层摄影(PET)/CT对早期活动性大动脉炎(TA)患者的诊断价值。方法病例对照研究。纳入西安交通大学第一附属医院2020年1月—2022年12月行PET/CT检查的10例早期活动性TA患者的临床资料,其中男2例、女8例,年龄20~72(44.9±17.7)岁,为TA组;选择同期年龄、性别匹配的10例非TA的受检者作为对照组,均行^(18)F-FDG PET/CT显像检查。观察研究对象的显像结果,由2位有经验的影像科医师分别勾画血管病变,测量TA组病变段血管壁与对照组主动脉段血管壁对^(18)F-FDG的最大标准摄取值(SUVmax),比较2组SUVmax的差异。采用Spearman相关性分析方法,探讨TA组病变动脉段血管壁局部对^(18)F-FDG的SUVmax值与红细胞沉降率(ESR)、C反应蛋白(CRP)的关系。结果10例早期活动性TA患者^(18)F-FDG PET/CT显像中均可看到主动脉及其主要分支血管壁葡萄糖代谢轻至中度增高。TA组的^(18)F-FDG SUVmax值为3.38±0.85,明显高于对照组的1.68±0.24,差异有统计学意义(t=6.12,P<0.001)。TA组的^(18)F-FDG SUVmax值与ESR无相关性(r_(s)=0.489,P=0.151),与CRP呈正相关(r_(s)=0.758,P=0.011),ESR与CRP间无相关性(r_(s)=0.479,P=0.162)。结论^(18)F-FDG PET/CT可准确显示TA的病变范围,并通过血管壁的SUVmax反映TA的活动性,是诊断早期活动性TA的一种可靠的影像学手段。

Objective This paper investigates the diagnostic value of^(18)F-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^(18)F-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.Results^(18)F-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(r_(s)=0.489,P=0.151)but was positively correlated with CRP(r_(s)=0.758,P=0.011),and no correlation existed between ESR and CRP(r_(s)=0.479,P=0.162).Conclusion^(18)F-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.