Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Pisa and Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
Cardiology and Cardiovascular Medicine Unit, Fondazione "Gabriele Monasterio" CNR/Regione Toscana, University of Pisa and Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
Clin Exp Rheumatol. 2021 Mar-Apr;39 Suppl 129(2):76-82. doi: 10.55563/clinexprheumatol/3cneda. Epub 2020 Dec 9.
Large vessel vasculitis (LVV) are chronic inflammatory diseases that affect arteries. While a mere clinical-serological approach does not seem sensitive either in the initial evaluation nor in long-term monitoring, 18-FDG positron emission tomography (18-FDG PET) is currently considered a useful assessment tool in LVV. We aimed at exploring the utility of 18-FDG, compared with traditional assessments, in the short- and long-term follow-up of patients with LVV. In addition, we compared patterns of vascular involvement in patients with Takayasu's arteritis (TAK) and giant cell arteritis (GCA).
We retrospectively analysed 47 patients affected by LVV, evaluating clinics, blood chemistry and 18-FDG PET results, at two time points, short-term (average 8 months after diagnosis) and long-term (average 29 months).
18-FDG PET uptake, expressed as mean value of SUV max, decreased significantly during follow-up in all the patients. A low concordance between 18-FDG PET and acute phase reactants levels was observed, but also a good sensitivity in detecting the response to treatment.
The results confirm the role of 18-FDG PET as a powerful tool in the evaluation of LVV, both at the time of diagnosis and during monitoring. Furthermore, the data confirm that GCA and TAK are part of the same disease spectrum.
大血管血管炎（LVV）是一种慢性炎症性疾病，影响动脉。虽然仅通过临床-血清学方法在初始评估和长期监测中似乎都不敏感，但 18-FDG 正电子发射断层扫描（18-FDG PET）目前被认为是 LVV 的一种有用的评估工具。我们旨在探讨 18-FDG 在 LVV 患者的短期和长期随访中与传统评估相比的效用。此外，我们比较了 Takayasu 动脉炎（TAK）和巨细胞动脉炎（GCA）患者的血管受累模式。
我们回顾性分析了 47 例 LVV 患者，在两个时间点（诊断后平均 8 个月和平均 29 个月）评估临床、血液化学和 18-FDG PET 结果。
所有患者的 18-FDG PET 摄取（以 SUV max 的平均值表示）在随访过程中均显著下降。18-FDG PET 与急性期反应物水平之间的一致性较低，但在检测治疗反应方面具有良好的敏感性。
这些结果证实了 18-FDG PET 在 LVV 的评估中的作用，无论是在诊断时还是在监测期间，都是一种强大的工具。此外，这些数据证实 GCA 和 TAK 是同一疾病谱的一部分。
