Boursier Caroline, Duval Xavier, Mahida Besma, Hoen Bruno, Goehringer François, Selton-Suty Christine, Chevalier Elodie, Roch Véronique, Lamiral Zohra, Bourdon Aurélie, Piriou Nicolas, Pallardy Amandine, Morel Olivier, Rouzet François, Marie Pierre-Yves
Université de Lorraine, 54000, Nancy, France.
Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France.
J Nucl Cardiol. 2021 Dec;28(6):2533-2542. doi: 10.1007/s12350-020-02050-2. Epub 2020 Feb 10.
This study aimed at determining the diagnostic implications of indirect signs of infection at FDG-PET-i.e., hypermetabolisms of the spleen and/or bone marrow (HSBM)-when documented in patients with known or suspected infective endocarditis (IE).
HSBM were defined by higher mean standardized uptake values comparatively to that of the liver on FDG-PET images from patients with a high likelihood of IE and prospectively included in a multicenter study.
Among the 129 included patients, IE was ultimately deemed as definite in 88 cases. HSBM was a predictor of definite IE (P = 0.014; odds ratio (OR) 3.2), independently of the criterion of an abnormal cardiac FDG uptake (P = 0.0007; OR 9.68), and a definite IE was documented in 97% (29/30) of patients showing both HSBM and abnormal cardiac uptake, 78% (7/9) of patients with only abnormal cardiac uptake, 67% (42/63) of patients with only HSBM, and 37% (10/27) of patients with neither one.
In this cohort with a high likelihood of IE, HSBM is an additional albeit indirect sign of IE, independently of the criterion of an abnormal cardiac uptake, and could reinforce the suspicion of IE in the absence of any other infectious, inflammatory, or malignant disease.
本研究旨在确定在已知或疑似感染性心内膜炎（IE）患者中，FDG-PET上感染的间接征象，即脾脏和/或骨髓代谢增高（HSBM）的诊断意义。
HSBM定义为来自IE可能性高的患者的FDG-PET图像上，相对于肝脏平均标准化摄取值更高，这些患者前瞻性纳入一项多中心研究。
在纳入的129例患者中，最终88例被判定为确诊IE。HSBM是确诊IE的一个预测指标（P = 0.014；比值比（OR）3.2），独立于心脏FDG摄取异常这一标准（P = 0.0007；OR 9.68），在同时出现HSBM和心脏摄取异常的患者中有97%（29/30）确诊为IE，仅心脏摄取异常的患者中有78%（7/9）确诊，仅有HSBM的患者中有67%（42/63）确诊，两者均无的患者中有37%（10/27）确诊。
在这个IE可能性高的队列中，HSBM是IE的一个额外的间接征象，独立于心脏摄取异常这一标准，并且在没有任何其他感染、炎症或恶性疾病时可增强对IE的怀疑。
