Rubin David T, Surma Bonnie L, Gavzy Samuel J, Schnell Kerry M, Bunnag Alana P, Huo Dezheng, Appelbaum Daniel E
Inflammatory Bowel Disease Center, Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA.
Inflamm Bowel Dis. 2009 May;15(5):750-5. doi: 10.1002/ibd.20819.
Positron emission tomography (PET) using 18-fluorodeoxyglucose (18-FDG) is a noninvasive, functional imaging modality most often used to assess cancer. The aim of this study was to perform PET/computed tomography (CT) on patients with quiescent ulcerative colitis (UC) to understand the limits of this technology for assessing inflammatory activity.
We identified patients diagnosed with UC in a strictly defined remission state. PET/CT was performed in standard fashion, using approximately 10 mCi of 18-FDG with a 60-minute uptake delay. Uptake in each of 4 colonic segments (recto-sigmoid [r-s], descending, transverse, and ascending), and distal small bowel were scored on a 3-point scale (0 = no uptake or uptake <or=liver; 1 = uptake somewhat >liver; 2 = uptake much greater than liver).
Ten patients participated in this study, 6 male. Eight had pancolitis, 1 had extensive colitis, and 1 had procto-sigmoiditis, with a median disease duration was 32 years. A PET scan was performed mean 37 days after endoscopy. Six patients had no increased 18-FDG uptake, 3 had increased uptake in the r-s region, 1 patient with r-s uptake also had ascending colon uptake, and 1 had ileal uptake with no colonic signal.
In this study, PET demonstrated inflammatory activity in the colon despite negative endoscopic, histologic, and symptom assessment. This has important implications in the understanding of UC disease quiescence. Further exploration of this highly sensitive modality should be performed.
使用18-氟脱氧葡萄糖（18-FDG）的正电子发射断层扫描（PET）是一种非侵入性的功能成像方式，最常用于评估癌症。本研究的目的是对静止期溃疡性结肠炎（UC）患者进行PET/计算机断层扫描（CT），以了解该技术在评估炎症活动方面的局限性。
我们确定了诊断为处于严格定义的缓解状态的UC患者。以标准方式进行PET/CT，使用约10 mCi的18-FDG，摄取延迟60分钟。对4个结肠段（直肠乙状结肠[r-s]、降结肠、横结肠和升结肠）以及远端小肠的摄取情况进行3分制评分（0 = 无摄取或摄取≤肝脏；1 = 摄取略大于肝脏；2 = 摄取远大于肝脏）。
10名患者参与了本研究，其中6名男性。8例为全结肠炎，1例为广泛性结肠炎，1例为直肠乙状结肠炎，疾病中位病程为32年。PET扫描在内镜检查后平均37天进行。6名患者18-FDG摄取无增加，3名患者r-s区域摄取增加，1名r-s摄取增加的患者升结肠也有摄取，1名患者回肠有摄取但结肠无信号。
在本研究中，尽管内镜、组织学和症状评估均为阴性，但PET显示结肠存在炎症活动。这对理解UC疾病静止期具有重要意义。应对这种高敏感性的检查方式进行进一步探索。
