Bucerius Jan
Department of Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands -
Q J Nucl Med Mol Imaging. 2016 Sep;60(3):219-35. Epub 2016 Jun 9.
Whereas in the past the term "vasculitis" was most frequently used in context with systemic vasculitides, such as the large vessel vasculitides (LVV) Takayasa arteritis and giant cell arteritis, characterized by inflammation of blood vessel walls, it nowadays comprises also inflammatory changes of the vessel wall as a substantial part of the atherosclerotic disease process. Implementing non-invasive imaging techniques, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA) as well as positron emission tomography (PET) in the diagnostic algorithm of atherosclerosis and LVV, depicts a promising step towards an earlier detection with a, consecutively, improved therapeutic approach and potentially prognostic benefit in patients suffering from vasculitis. Mainly molecular imaging with 18F-fluorodeoxyglucose (FDG) PET seems to be promising in offering an early and sensitive identification of inflammatory changes in both, atherosclerosis and LVV. This review will therefore provide an overview on the diagnostic performance and clinical relevance of FDG-PET in monitoring vasculitis in atherosclerosis and LVV, with a focus on LVV.
过去,“血管炎”一词最常用于全身性血管炎的语境中,如大动脉血管炎(LVV),包括高安动脉炎和巨细胞动脉炎,其特征是血管壁炎症。如今,血管壁的炎症变化也被视为动脉粥样硬化疾病过程的重要组成部分。在动脉粥样硬化和LVV的诊断流程中采用计算机断层扫描血管造影(CTA)、磁共振血管造影(MRA)以及正电子发射断层扫描(PET)等非侵入性成像技术,是朝着早期检测迈出的有前景的一步,这继而能改善治疗方法,并有望为血管炎患者带来预后益处。主要是使用18F-氟脱氧葡萄糖(FDG)PET的分子成像,似乎有望早期且灵敏地识别动脉粥样硬化和LVV中的炎症变化。因此,本综述将概述FDG-PET在监测动脉粥样硬化和LVV中的血管炎方面的诊断性能和临床相关性,重点是LVV。