Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
J Clin Neurol. 2013 Jul;9(3):176-85. doi: 10.3988/jcn.2013.9.3.176. Epub 2013 Jul 1.
To estimate clinical roles of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus angiography and ultrasonography in carotid plaque characterization.
We characterized two groups of patients with recently (<1 month) symptomatic (n=14; age=71.8±8.6 years, mean±SD) or chronic (n=13, age=68.9±9.0 years) carotid stenosis using a battery of imaging tests: diffusion magnetic resonance (MR) imaging, MR or transfemoral angiography, duplex ultrasonography (DUS), and carotid FDG-PET/computed tomography.
The degree of angiographic stenosis was greater in patients with recently symptomatic carotid plaques (67.5±21.5%) than in patients with chronic carotid plaques (32.4±26.8%, p=0.001). Despite the significant difference in the degree of stenosis, lesional maximum standardized uptake values (maxSUVs) on the carotid FDG-PET did not differ between the recently symptomatic (1.56±0.53) and chronic (1.56±0.34, p=0.65) stenosis groups. However, lesional-to-contralesional maxSUV ratios were higher in the recently symptomatic stenosis group (113±17%) than in the chronic stenosis group (98±10%, p=0.017). The grayscale median value of the lesional DUS echodensities was lower in the recently symptomatic stenosis group (28.2±10.0, n=9) than in the chronic stenosis group (53.9±14.0, n=8; p=0.001). Overall, there were no significant correlations between angiographic stenosis, DUS echodensity, and FDG-PET maxSUV. Case/subgroup analyses suggested complementarity between imaging modalities.
There were both correspondences and discrepancies between the carotid FDG-PET images and DUS or angiography data. Further studies are required to determine whether FDG-PET could improve the clinical management of carotid stenosis.
评估 18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）与血管造影和超声检查在颈动脉斑块特征分析中的临床作用。
我们对两组近期（<1 个月）有症状（n=14；年龄=71.8±8.6 岁，均值±标准差）或慢性（n=13，年龄=68.9±9.0 岁）颈动脉狭窄患者使用一系列影像学检查进行特征分析：弥散磁共振（MR）成像、MR 或经股血管造影、双功能超声（DUS）和颈动脉 FDG-PET/CT。
近期有症状颈动脉斑块患者的血管造影狭窄程度（67.5±21.5%）大于慢性颈动脉斑块患者（32.4±26.8%，p=0.001）。尽管狭窄程度有显著差异，但颈动脉 FDG-PET 的病变最大标准化摄取值（maxSUV）在近期有症状（1.56±0.53）和慢性（1.56±0.34，p=0.65）狭窄组之间没有差异。然而，近期有症状狭窄组的病变与对侧 maxSUV 比值（113±17%）高于慢性狭窄组（98±10%，p=0.017）。近期有症状狭窄组的病变 DUS 回声密度灰度中位数（28.2±10.0，n=9）低于慢性狭窄组（53.9±14.0，n=8；p=0.001）。总体而言，血管造影狭窄、DUS 回声密度和 FDG-PET maxSUV 之间没有显著相关性。病例/亚组分析表明，各种影像学方法之间具有互补性。
颈动脉 FDG-PET 图像与 DUS 或血管造影数据之间既有一致性又有差异。需要进一步的研究来确定 FDG-PET 是否可以改善颈动脉狭窄的临床管理。
