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F-FDG-PET/CT:评估大动脉炎活动的准确方法。

F-FDG-PET/CT: an accurate method to assess the activity of Takayasu's arteritis.

机构信息

Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Clin Rheumatol. 2018 Jul;37(7):1927-1935. doi: 10.1007/s10067-017-3960-7. Epub 2018 Jan 3.

Abstract

The objective of the study is to investigate the value of F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-FDG-PET/CT) for assessment of the activity of Takayasu's arteritis (TA) and the correlation between acute-phase reactive proteins (ARPs) and standard uptake value (SUV). Analyses of the clinical characteristics and 42 F-FDG-PET/CT scans in 39 TA patients were undertaken. The degree of FDG uptake in the blood vessel walls was assessed quantitatively by SUV. TA activity was analyzed by physician global assessment (PGA). Clinical and F-FDG-PET/CT characteristics were compared between patients with clinically active and clinically inactive TA. Maximum SUV (SUV), mean SUV (SUV), and SUV ratio (SUV) were significantly higher in the clinically active group than in the clinically inactive group (3.63 ± 1.96 vs. 1.82 ± 0.43, p = 0.007; 2.07 ± 0.71 vs. 1.43 ± 0.32, p = 0.009; 2.08 ± 1.17 vs. 0.95 ± 0.19, p = 0.000). Analyses of receiver operating characteristic (ROC) curves revealed a cutoff value of SUV of 2.21, with sensitivity and specificity of 86.2 and 90.0%, respectively, for clinically active TA. The SUV cutoff was 1.27 with a sensitivity and specificity of 79.3 and 100.0%, respectively. SUV was slightly superior to SUV and ARPs in the area under the curve (AUC) comparison. SUV and SUV showed a significant increasing trend with increasing US National Institutes of Health (NIH) score and levels of ARPs, interleukin-6, and serum amyloid-A protein. F-FDG-PET/CT is a promising non-invasive, quantitative measurement with high sensitivity and specificity for determining TA activity.

摘要

本研究旨在探讨氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(F-FDG-PET/CT)在评估大动脉炎(TA)活动中的价值,以及急性期反应蛋白(ARPs)与标准摄取值(SUV)之间的相关性。分析了 39 例 TA 患者的 42 次 F-FDG-PET/CT 扫描的临床特征。通过 SUV 对血管壁的 FDG 摄取程度进行定量评估。通过医生整体评估(PGA)分析 TA 活动。比较了临床活动期和临床非活动期 TA 患者的临床和 F-FDG-PET/CT 特征。临床活动组的最大 SUV(SUV)、平均 SUV(SUV)和 SUV 比值(SUV)均显著高于临床非活动组(3.63±1.96 vs. 1.82±0.43,p=0.007;2.07±0.71 vs. 1.43±0.32,p=0.009;2.08±1.17 vs. 0.95±0.19,p=0.000)。受试者工作特征(ROC)曲线分析显示,SUV 截断值为 2.21,对临床活动期 TA 的敏感性和特异性分别为 86.2%和 90.0%。SUV 截断值为 1.27,敏感性和特异性分别为 79.3%和 100.0%。SUV 在曲线下面积(AUC)比较中略优于 SUV 和 ARPs。SUV 和 SUV 与美国国立卫生研究院(NIH)评分和 ARPs、白细胞介素-6 和血清淀粉样蛋白 A 水平的升高呈显著正相关。F-FDG-PET/CT 是一种很有前途的非侵入性、定量测量方法,具有较高的敏感性和特异性,可用于确定 TA 活动度。

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