Urbak Laerke, Ripa Rasmus S, Sandholt Benjamin V, Kjaer Andreas, Sillesen Henrik, Graebe Martin
Department of Vascular Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
EJNMMI Res. 2021 Mar 23;11(1):30. doi: 10.1186/s13550-021-00773-y.
Atherosclerotic plaque vulnerability is comprised by plaque composition driven by inflammatory activity and these features can be depicted with 3D ultrasound and 2-[18F]FDG-PET, respectively. The study investigated timely changes in carotid artery plaque inflammation and morphology after a thromboembolic event with PET/CT and novel ultrasound volumetric grayscale median (GSM) readings. Patients with a single hemisphere-specific neurological symptom and the presence of an ipsilateral carotid artery atherosclerotic plaque were prospectively included to both 2-[18F]FDG PET/CT and 3D ultrasound scans of the plaque immediately after their event and again three months later. On PET/CT images the maximum standardized uptake value (SUV) was measured and the volumetric ultrasound acquisitions were analyzed using a semiautomated software measuring GSM values.
Baseline scans were performed by a mean of 7 days (range 2-14) after the symptom and again after 98 days (range 91-176). For the entire group (n = 14), we found a decrease in average SUV from baseline to follow-up of - 0.18 (95% confidence interval: - 0.34 to - 0.02, P = 0.034). GSM did not increase significantly over time (mean change: + 2.21, 95% confidence interval: - 17.02 to 21.44, P = 0.808).
A decrease in culprit lesion 2-[18F]FDG-uptake 3 months after an event indicates a decrease in inflammatory activity, suggesting that carotid plaque stabilization over time. 3D ultrasound morphological quantitative differences in GSM were not detectable after 3 months.
动脉粥样硬化斑块易损性由炎症活动驱动的斑块成分构成，这些特征可分别通过三维超声和2-[¹⁸F]氟代脱氧葡萄糖正电子发射断层扫描（2-[¹⁸F]FDG-PET）来描绘。本研究利用PET/CT和新型超声体积灰度中位数（GSM）读数，调查了血栓栓塞事件后颈动脉斑块炎症和形态的即时变化。前瞻性纳入有单一半球特异性神经症状且同侧颈动脉存在动脉粥样硬化斑块的患者，在事件发生后立即及3个月后分别进行2-[¹⁸F]FDG PET/CT和斑块的三维超声扫描。在PET/CT图像上测量最大标准化摄取值（SUV），并使用测量GSM值的半自动软件分析超声体积采集数据。
症状出现后平均7天（范围2 - 14天）进行基线扫描，98天（范围91 - 176天）后再次扫描。对于整个队列（n = 14），我们发现从基线到随访时平均SUV下降了-0.18（95%置信区间：-0.34至-0.0²，P = 0.034）。GSM并未随时间显著增加（平均变化：+2.21，95%置信区间：-17.02至21.44，P = 0.808）。
事件发生3个月后罪犯病变的2-[¹⁸F]FDG摄取降低表明炎症活动减少，提示颈动脉斑块随时间推移趋于稳定。3个月后未检测到GSM的三维超声形态学定量差异。
