使用正电子发射断层扫描术探讨风湿性多肌痛血管炎本质的新论据。

New arguments for a vasculitic nature of polymyalgia rheumatica using positron emission tomography.

作者信息

Blockmans D, Maes A, Stroobants S, Nuyts J, Bormans G, Knockaert D, Bobbaers H, Mortelmans L

机构信息

Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.

出版信息

Rheumatology (Oxford). 1999 May;38(5):444-7. doi: 10.1093/rheumatology/38.5.444.

DOI:10.1093/rheumatology/38.5.444

PMID:10371283

Abstract

OBJECTIVE

To study the possible contribution of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in the diagnosis of giant cell arteritis and polymyalgia rheumatica.

METHODS

A consecutive case series consisting of five patients with polymyalgia rheumatica, six patients with temporal arteritis and 23 age-matched patients with other inflammatory conditions were evaluated with FDG-PET. Studies were performed before therapy with steroids was started.

RESULTS

A total of 4/6 patients with giant cell arteritis and 4/5 patients with polymyalgia had increased FDG uptake in their thoracic vessels, compared to 1/23 controls (P < 0.001). Increased vascular FDG uptake in the upper legs was seen in 8/11 patients with giant cell arteritis or polymyalgia compared to 8/23 control patients (P < 0.05), and in the lower legs in 6/11 patients compared to 6/23 controls (P = not significant).

CONCLUSIONS

FDG-PET scan is the first non-invasive technique which may indicate large-vessel vasculitis and which can show its extension throughout the body. It strongly suggests that polymyalgia rheumatica is a form of vasculitis.

摘要

目的

研究氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）在巨细胞动脉炎和风湿性多肌痛诊断中的可能作用。

方法

对连续的病例系列进行评估，该系列包括5例风湿性多肌痛患者、6例颞动脉炎患者以及23例年龄匹配的患有其他炎症性疾病的患者，均接受FDG-PET检查。检查在开始使用类固醇治疗之前进行。

结果

与23例对照患者中的1例相比，6例巨细胞动脉炎患者中有4例以及5例风湿性多肌痛患者中有4例在其胸部血管中出现FDG摄取增加（P < 0.001）。与23例对照患者中的8例相比，11例巨细胞动脉炎或风湿性多肌痛患者中有8例在上腿部出现血管FDG摄取增加（P < 0.05），而在小腿部，11例患者中有6例出现血管FDG摄取增加，对照患者中有6例（P = 无显著性差异）。