Jeong Yun-Jeong, Paeng Jin Chul, Nam Hyun-Yeol, Lee Ji Sun, Lee Sang-Min, Yoo Chul-Gyu, Kim Young Whan, Han Sung Koo, Yim Jae-Joon
Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2014 Mar;29(3):386-91. doi: 10.3346/jkms.2014.29.3.386. Epub 2014 Feb 27.
The presence of radiographic lesions suggesting old healed tuberculosis (TB) is one of the strongest risk factors for the subsequent development of active TB. We elucidated the metabolic activity of radiographic lesions suggesting old healed TB using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT). This cross-sectional study included 63 participants with radiographic lesions suggesting old healed TB and with available (18)F-FDG PET/CT scans. The maximum standardized uptake value (SUVmax) measured in the lesions, the clinical characteristics, results of the tuberculin skin test (TST) and interferon-γ release assay (IGRA) were analyzed. The SUVmax in old healed TB was 1.5 or higher among nine (14.3%) participants. Age (adjusted odds ratio [aOR], 1.23; 95% CI, 1.03-1.46), history of previous TB (aOR, 60.43; 95% CI, 1.71-2131.65), and extent of the lesions (aOR, 1.34; 95% CI, 1.02-1.75) were associated with higher SUVmax. The positive rates for the TST and IGRA were not different between groups with and without increased FDG uptake. Increased FDG uptake on (18)F-FDG PET/CT was observed in a subset of patients with radiographic lesions suggesting old healed TB. Given that the factors associated with increased FDG uptake are known risk factors for TB development, the possibility exists that participants with old healed TB lesions with higher SUV on (18)F-FDG PET/CT scans might be at higher risk for active TB.
影像学表现提示陈旧性愈合肺结核（TB）是后续发生活动性TB的最强危险因素之一。我们使用（18）F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（（18）F-FDG PET/CT）阐明了影像学表现提示陈旧性愈合TB的代谢活性。这项横断面研究纳入了63名有影像学表现提示陈旧性愈合TB且有可用（18）F-FDG PET/CT扫描的参与者。分析了病变处测得的最大标准化摄取值（SUVmax）、临床特征、结核菌素皮肤试验（TST）结果和干扰素-γ释放试验（IGRA）结果。在9名（14.3%）参与者中，陈旧性愈合TB的SUVmax为1.5或更高。年龄（调整优势比[aOR]，1.23；95%可信区间[CI]，1.03 - 1.46）、既往TB病史（aOR，60.43；95%CI，1.71 - 2131.65）和病变范围（aOR，1.34；95%CI，1.02 - 1.75）与较高的SUVmax相关。TST和IGRA的阳性率在FDG摄取增加和未增加的组之间没有差异。在一部分有影像学表现提示陈旧性愈合TB的患者中观察到（18）F-FDG PET/CT上FDG摄取增加。鉴于与FDG摄取增加相关的因素是TB发生的已知危险因素，对于（18）F-FDG PET/CT扫描上SUV较高的陈旧性愈合TB病变参与者，有可能发生活动性TB的风险更高。
