Bucci Monica, Aparici Carina Mari, Hawkins Randy, Bacharach Steve, Schrek Carole, Cheng Suchun, Tong Elizabeth, Arora Sandeep, Parati Eugenio, Wintermark Max
Department of Radiology, Neuroradiology Section, University of California, San Francisco, CA; Department of Neurology, Cerebrovascular Unit, Neurological Institute Carlo Besta, Milan, Italy.
J Neuroimaging. 2014 Mar-Apr;24(2):117-23. doi: 10.1111/j.1552-6569.2012.00740.x. Epub 2012 Aug 28.
From the literature, the prevalence of fluorodeoxyglucose (FDG) uptake in large artery atherosclerotic plaques shows great heterogeneity. We retrospectively reviewed 100 consecutive patients who underwent FDG-positron emission tomography-computed tomography (PET/CT) imaging of their whole body, to evaluate FDG uptake in the arterial wall.
We retrospectively evaluated 100 whole-body PET-CT scans. The PET images coregistered with CT were reviewed for abnormal 18F-FDG uptake. The mean standard uptake value (SUV) was measured in regions of interest (ROIs). The prevalence of PET+ plaques was determined based on the qualitative PET review, used as the gold standard in a receiver-operating characteristic (ROC) curve analysis to determine an optimal threshold for the quantitative PET analysis.
The qualitative, visual assessment demonstrated FDG uptake in the arterial walls of 26 patients. A total of 85 slices exhibited FDG uptake within the arterial wall of 37 artery locations. 11, 17, and 2 patients exhibited FDG uptake within the wall of carotid arteries, of the aorta, and of the iliac arteries, respectively. Only 4 of the 26 patients had positive FDG uptake in more than one artery location. In terms of quantitative analysis, a threshold of 2.8 SUV was associated with a negative predictive value of 99.4% and a positive predictive value of 100% to predict qualitative PET+ plaques. A threshold of 1.8 SUV was associated with a negative predictive value of 100% and a positive predictive value of 99.4%. Area under the ROC curve was .839.
The prevalence of PET uptake in arterial walls in a consecutive population of asymptomatic patients is low and usually confined to one type of artery, and its clinical relevance in terms of vulnerability to ischemic events remains to be determined.
从文献中可知，大动脉粥样硬化斑块中氟脱氧葡萄糖（FDG）摄取的患病率存在很大异质性。我们回顾性分析了100例连续接受全身FDG正电子发射断层扫描-计算机断层扫描（PET/CT）成像的患者，以评估动脉壁中的FDG摄取情况。
我们回顾性评估了100例全身PET-CT扫描。对与CT配准的PET图像进行异常18F-FDG摄取情况的检查。在感兴趣区域（ROI）测量平均标准摄取值（SUV）。基于定性PET检查确定PET阳性斑块的患病率，并将其用作受试者操作特征（ROC）曲线分析中的金标准，以确定定量PET分析的最佳阈值。
定性的视觉评估显示，26例患者的动脉壁有FDG摄取。共有85个层面在37个动脉部位的动脉壁内显示FDG摄取。分别有11例、17例和2例患者在颈动脉壁、主动脉壁和髂动脉壁内有FDG摄取。26例患者中只有4例在多于一个动脉部位有FDG摄取阳性。在定量分析方面，2.8 SUV的阈值与预测定性PET阳性斑块的阴性预测值99.4%和阳性预测值100%相关。1.8 SUV的阈值与阴性预测值100%和阳性预测值99.4%相关。ROC曲线下面积为0.839。
在连续的无症状患者群体中，动脉壁PET摄取的患病率较低，且通常局限于一种动脉类型，其在缺血事件易损性方面的临床相关性仍有待确定。
