Rheumatology Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; University of Modena and Reggio Emilia, Modena, Italy.
Rheumatology Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy.
Semin Arthritis Rheum. 2019 Jun;48(6):1074-1082. doi: 10.1016/j.semarthrit.2018.10.003. Epub 2018 Oct 12.
To evaluate aortic diameter and predictors of aortic dilatation using FDG-PET/CT in a longitudinally followed cohort of patients with large vessel vasculitis (LVV) compared with controls.
All consecutive patients with LVV who underwent at least 2 PET/CT scans between January 2008 and May 2015 were included. The first and last PET/CT study was evaluated by a radiologist and a nuclear medicine physician. Diameter and FDG uptake of the aorta was measured at 4 different levels: ascending, descending thoracic, suprarenal and infrarenal abdominal aorta. Twenty-nine age- and sex-matched patients with lymphoma who underwent at least 2 PET/CT scans in the same time interval were selected as controls.
93 patients with LVV were included in the study. In the time interval between first and last PET/CT study (median time 31 months), the diameter of the ascending, descending thoracic and suprarenal abdominal aorta significantly increased in LVV patients but not in controls. At last PET/CT, patients with LVV compared with controls had higher diameter of ascending [35.41 (5.54) vs 32.97 (4.11) mm, p = 0.029], descending thoracic [28.42 (4.82) vs 25.72 (3.55) mm, p = 0.007] and suprarenal abdominal aorta, mean [25.34 (7.01) vs 22.16 (3.26) mm, p = 0.005] and more frequently had aortic dilatation [19% vs 3%, p = 0.023]. Significant predictors of aortic dilatation were male sex [OR 7.27, p = 0.001] and, only for GCA, hypertension [OR 6.30, p = 0.031]. Finally, GCA patients with aortic FDG uptake grade 3 at first PET/CT, compared to those with aortic FDG uptake ≤2, had significantly higher aortic diameter.
Patients with LVV are at increased risk of aortic dilatation compared with age- and sex-matched controls. Significant predictors of aortic dilatation are male sex and, only for GCA, hypertension. GCA patients with aortic FDG uptake grade 3 are at increased risk of aortic dilatation.
通过使用 FDG-PET/CT 评估一组经纵向随访的大血管血管炎（LVV）患者与对照组之间的主动脉直径及其扩张的预测因素。
纳入 2008 年 1 月至 2015 年 5 月期间至少接受 2 次 PET/CT 扫描的所有连续 LVV 患者。第一次和最后一次 PET/CT 研究由放射科医生和核医学医生进行评估。在 4 个不同水平测量主动脉的直径和 FDG 摄取：升主动脉、降主动脉、肾上腹主动脉和肾下腹主动脉。选择 29 名年龄和性别匹配的淋巴瘤患者，这些患者在相同的时间间隔内接受了至少 2 次 PET/CT 扫描作为对照。
共纳入 93 例 LVV 患者进行研究。在第一次和最后一次 PET/CT 检查之间的时间间隔内（中位时间为 31 个月），LVV 患者的升主动脉、降主动脉和肾上腹主动脉直径显著增加，但对照组患者无此变化。在最后一次 PET/CT 检查时，与对照组相比，LVV 患者的升主动脉[35.41（5.54）与 32.97（4.11）mm，p=0.029]、降主动脉[28.42（4.82）与 25.72（3.55）mm，p=0.007]和肾上腹主动脉直径更大，平均值[25.34（7.01）与 22.16（3.26）mm，p=0.005]，且更常发生主动脉扩张[19%与 3%，p=0.023]。主动脉扩张的显著预测因素为男性[比值比 7.27，p=0.001]，仅对于巨细胞动脉炎，高血压[比值比 6.30，p=0.031]也是其预测因素。最后，与首次 PET/CT 主动脉 FDG 摄取≤2 级的巨细胞动脉炎患者相比，首次 PET/CT 主动脉 FDG 摄取 3 级的巨细胞动脉炎患者的主动脉直径显著更高。
与年龄和性别匹配的对照组相比，LVV 患者发生主动脉扩张的风险增加。主动脉扩张的显著预测因素为男性，仅对于巨细胞动脉炎，高血压也是其预测因素。巨细胞动脉炎患者的主动脉 FDG 摄取 3 级时，发生主动脉扩张的风险增加。
