Cardiac Surgery Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Nuclear Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Eur J Cardiothorac Surg. 2021 Jul 14;60(1):148-154. doi: 10.1093/ejcts/ezab017.
Our goal was to define characteristic patterns of 18F-fluorodeoxyglucose in non-infected patients with ascending aortic prosthetic grafts during the first year after surgery.
18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) was performed at 3, 6 and 12 months postoperatively in 26 uninfected patients. Clinical, analytical and microbiological (blood culture) assessments were performed to confirm the absence of infection. FDG uptake intensity [measured through maximum standardized uptake values (SUVmax) and the target-to-background ratio] and distribution patterns were obtained. Models of generalized estimating equations were used to assess the evolution of the SUVmax over time. The results were compared to those in our endocarditis-over-ascending-aortic-graft series database. The receiver operating characteristic curves of the control group and the 12-month group were assessed.
All patients showed increased uptake in all areas. The uptake pattern was heterogeneous in 47.4%, 43.5% and 42.3% at 3, 6 and 12 months. The means and standard deviations of the SUVmax in the graft were 4.80 (±0.99), 4.28 (±0.88) and 4.14 (±0.87) at 3, 6 and 12 months after surgery. A comparison of all values obtained in the 6th and 12th months compared to those from the 3rd month revealed a slow decrease that may persist after the first year. The cut-off value of SUVmax of 4.24 had an overall sensitivity of 84.6% and specificity of 57.7% for patients seen at 12 months.
Non-infected ascending aortic grafts showed no predominant uptake pattern; they also showed increased 18F-fluorodeoxyglucose activity that could persist beyond the first year. Caution is therefore recommended when interpreting PET/CT images obtained during the first year after surgery.
本研究旨在定义术后 1 年内非感染性升主动脉假体移植物患者 18F-氟脱氧葡萄糖（FDG）的特征性摄取模式。
26 例非感染患者于术后 3、6 和 12 个月分别行 18F-FDG 正电子发射断层扫描（PET）/计算机断层扫描（CT）检查。临床、实验室和微生物学（血培养）评估以确认无感染。获得 FDG 摄取强度（通过最大标准化摄取值[SUVmax]和靶-背景比测量）和分布模式。使用广义估计方程模型评估 SUVmax 随时间的变化。结果与我们的感染性心内膜炎合并升主动脉移植物数据库进行比较。评估对照组和 12 个月组的受试者工作特征曲线。
所有患者在所有区域均显示摄取增加。在 3、6 和 12 个月时，摄取模式分别有 47.4%、43.5%和 42.3%为异质性。术后 3、6 和 12 个月时移植物 SUVmax 的平均值和标准差分别为 4.80（±0.99）、4.28（±0.88）和 4.14（±0.87）。比较第 6 个月和第 12 个月与第 3 个月的所有测量值，发现 SUVmax 缓慢下降，这种下降可能在第 1 年后持续存在。SUVmax 的截断值为 4.24 时，12 个月时患者的总敏感性为 84.6%，特异性为 57.7%。
非感染性升主动脉移植物无明显摄取模式；FDG 活性也增加，且可能在术后第 1 年持续存在。因此，在术后第 1 年解读 PET/CT 图像时需谨慎。
