18F-FDG PET/CT显像在早期活动性大动脉炎诊断中的价值探讨

目的:探讨¹⁸F-FDG PET/CT在早期活动性大动脉炎患者中的诊断价值。方法:收集2010年1月—2019年9月潍坊市人民医院风湿免疫科住院并符合ACR诊断标准且在疾病早期完善了PET/CT检查的15例大动脉炎患者,收集并分析这些患者在疾病早期行PET/CT时的临床症状,采用独立样本t检验比较SUVmax值的差异性,SUVmax与炎症指标(包括血沉及C反应蛋白)做Spearman相关分析,以P<0.05为差异有统计学意义,并记录分析PET显像特点。结果:15例患者均处于活动期,血沉和C反应蛋白均有升高,平均SUVmax与C反应蛋白呈极强正相关(r=0.954,P<0.001),与血沉呈极弱相关性(r=0.098,P<0.01);最初就诊时符合ACR诊断标准的10例患者与不符合ACR诊断标准的5例患者的ESR、CRP及平均SUVmax差异无统计学意义(P>0.05),且在PET/CT显像中的FDG分布部位无明显差异,但10例符合ACR诊断标准的患者PET/CT图像显示相关主动脉及其主要分支明显狭窄。结论:¹⁸F-FDG PET/CT是一种检测早期动脉炎症变化的有效的方法,可用于早期活动性大动脉炎的诊断。

Investigation on the value of18F-FDG PET/CT imaging in diagnosis of early active arteritis

Objective:To investigate the diagnostic value of¹⁸F-FDG PET/CT in patients with early active arteritis.Methods:Fifteen patients with arteritis who met the ACR diagnostic criteria and underwent the PET/CT examination in the early stage of the disease were collected during the period of hospitalization in the Department of Rheumatology Immunology of Weifang People’s Hospital from January 2010 to September 2019.The clinical symptoms of these patients were collected and analyzed during the early stage of the disease.The differences of SUVmax values were compared by independent sample t-test.Spearman correlation analysis was performed between SUVmax and inflammatory indexes(including erythrocyte sedimentation rate and C reactive protein).The difference was statistically significant with P<0.05,and the characteristics of PET imaging were recorded and analyzed.Results:All 15 patients were in active phase with elevated ESR and C reactive protein.The mean SUVmax was positively correlated with C reactive protein(r=0.954,P<0.001)and weakly correlated with ESR(r=0.098,P<0.01).There was no significant difference in the ESR,CRP and mean SUVmax between 10 patients who met the ACR diagnostic criteria and 5 patients who did not meet the diagnostic criteria(P>0.05),and there was no significant difference in the FDG distribution in the imaging.However,the PET/CT images of 10 patients who met the ACR diagnostic criteria showed significant stenosis of the associated aorta and its main branches.Conclusion:¹⁸F-FDG PET/CT is an effective method to detect the changes of early arterial inflammation,which can be used in the diagnosis of early active arteritis.