18F-FDGPET／CT显像对多发性大动脉炎的临床应用  

Clinical application of 18F-FDG PET/CT in Takayasu arteritis

作　　者：王冬艳[1] 王跃涛[1] 邵晓梁[1] 吴敏[2] 杨彦松[1] 王小松[1] 邵小南[1] 

机构地区：[1]苏州大学附属第三医院、常州市第一人民医院核医学科,213003 [2]苏州大学附属第三医院、常州市第一人民医院风湿科,213003

出　　处：《中华核医学与分子影像杂志》2016年第4期340-344,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨多发性大动脉炎（TA）的18F-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、头臂干动脉、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（t＝10.40，P〈0.001）。（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。Objective To investigate the characteristics of ISF-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 I^F-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 JSF-FDG uptake and SUV of lesions were analyzed. Another 5 age- and gender-matched patients with slightly elevated tumor markers and normal results of ISF-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 descend- ing aorta, the abdominal aorta, the brachiocephalic trunk, the left/right common carotid, the left/right sub- clavian, the left/right brachial, the superior mesenteric, the left/right common iliac, the left/right renal, and the left/right femoral, and their SUV were measured respectively. Paired t test was used to analyze the difference of SUV between TA group and the control group. Results （1） IS 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, punetate 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 in-volved 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 SUVm,x range was 1.4-7.6, the highest SUVm~ was in the left subclavian artery （n= 2）, the right subclavian artery （n- 1 ） and the abdominal aorta artery （n=2）. （2）The SUV

关 键 词：TAKAYASU动脉炎 体层摄影术 发射型计算机 体层摄影术 x线计算机 脱氧葡萄糖 

分 类 号：R817.4[医药卫生—影像医学与核医学] R543.5[医药卫生—放射医学]