摘要目的 探讨多发性大动脉炎(TA)的18 F-FDG PET/CT显像特征及其临床应用价值.方法 2011年11月至2014年8月期间5例经临床证实的TA活动期男性患者[65 ～ 82(72.8±6.6)岁],确诊前行18F-FDG PET/CT显像,其中1例为治疗1年后病情稳定而复查18F-FDG PET/CT.分析其影像特征,观察病灶18F-FDG摄取情况.按性别和年龄匹配选择同时间段的5例肿瘤标志物轻度升高而18F-FDG PET/CT显像正常者作为对照组.将动脉分为升主动脉、主动脉弓、降主动脉、腹主动脉、头臂于动脉、左和(/)右颈动脉、左/右锁骨下动脉、左/右肱动脉、肠系膜上动脉、左/右髂动脉、左/右肾动脉、左/右股动脉共18段,测量其SUVmax,采用配对t检验比较TA组与对照组间的SUVmax.结果 (1)5例TA 18F-FDG PET/CT显像均表现为主动脉及其主要分支血管壁FDG弥漫性摄取增高,CT示多处动脉血管壁不均匀增厚、局部伴点条状钙化;5例TA患者均累及升主动脉、主动脉弓、降主动脉、腹主动脉、头臂干动脉、左/右锁骨下动脉、左/右颈动脉、左/右髂动脉,其中4例左/右肱动脉、左/右股动脉受累,2例肠系膜上动脉受累.SUVmax为1.4～7.6,2例最高SUVmax位于左侧锁骨下动脉,1例位于右侧锁骨下动脉,2例位于腹主动脉.(2)TA组与对照组主动脉及其主要分支血管壁的SUVmax分别为3.96±1.35和2.13±0.53,差异有统计学意义(f=10.40,P＜O.001).(3)1例TA患者治疗后病情稳定,主动脉及其主要分支血管壁FDG摄取较治疗前明显减低,其中左侧锁骨下动脉SUVmax由6.8降至3.2.结论 18F-FDG PET/CT显像有助于TA的诊断,可准确显示病变范围,反映TA活动性,并可用于疗效评估.

abstractsObjective To investigate the characteristics of 18F-FDG PET/CT imaging in Takayasu arteritis (TA) and its clinical value.Methods Five male patients with TA in active phase (age range:65-82 years;mean age:(72.8±6.6) years) from November 2011 to August 2014 were retrospectively analyzed.All patients underwent 18F-FDG PET/CT imaging,and one of them who was in stable phase after one year's treatment underwent follow-up PET/CT imaging.The characteristics of the abnormal 18F-FDG uptake and SUVmax of lesions were analyzed.Another 5 age-and gender-matched patients with slightly elevated tumor markers and normal results of 18F-FDG PET/CT imaging in the same period were selected as the control group.Arteries were divided into 18 segments,including the ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right common carotid,the left/right subclavian,the left/right brachial,the superior mesenteric,the left/right common iliac,the left/right renal,and the left/right femoral,and their SUVmax were measured respectively.Paired t test was used to analyze the difference of SUVmax between TA group and the control group.Results (1) 18 F-FDG PET/CT imaging displayed diffused increase of radioactivity in the wall of aorta and its major branches in TA group,and CT showed multiple irregular thickening,punctate and banding calcification in arterial walls of those patients.The ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right subclavian,the left/right common carotid,and the left/right common iliac artery were all involved in 5 patients;the left/right brachial and the left/right femoral artery were involved in 4 patients and the superior mesenteric artery was involved in 2 cases.The SUVmax range was 1.4-7.6,the highest SUVmax was in the left subclavian artery (n=2),the right subclavian artery (n=1) and the abdominal aorta artery (n=2).(2)The SUVmax of TA group and the control group were 3.96±1.35 and 2.13±0.53,respectively(t=10.40,P＜0.001).(3) As to the TA patient in stable phase after treatment,the FDG uptake of the wall of aorta and its major branches decreased obviously compared with that before treatment.The SUVmax of left subclavian artery decreased from 6.8 to 3.2.Conclusions 18F-FDG PET/CT is helpful in diagnosis of TA.It could accurately display the range of involved arteries,reflect the activity of the lesion and evaluate the therapeutic response.