Kiatkittikul Peerapon, Promteangtrong Chetsadaporn, Kunawudhi Anchisa, Siripongsatian Dheeratama, Siripongboonsitti Taweegrit, Ruckpanich Piyanuj, Thongdonpua Supachoke, Jantarato Attapon, Piboonvorawong Chaiyawat, Fonghoi Nirawan, Chotipanich Chanisa
National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Nucl Med Mol Imaging. 2022 Feb;56(1):29-41. doi: 10.1007/s13139-021-00730-6. Epub 2022 Jan 15.
The study aimed to investigate imaging abnormalities associated with post-acute COVID-19 using F-18 FDG PET/CT and PET/ rsfMRI brain.
We retrospectively recruited 13 patients with post-acute COVID-19. The post-acute COVID-19 symptoms and neuropsychiatric tests were performed before F-18 FDG PET/CT whole body with PET/rsfMRI brain. Qualitative and semiquantitative analyses were also conducted in both whole body and brain images.
Among the 13 patients, 8 (61.5%) had myositis, followed by 8 (61.5%) with vasculitis (mainly in the thoracic aorta), and 7 (53.8%) with lung abnormalities.. Interestingly, one patient with a very high serum RBD IgG antibody demonstrated diffuse myositis throughout the body which potentially associated with immune-mediated myositis. One patient experienced psoriasis exacerbation with autoimmune-mediated after COVID-19. Most patients had multiple areas of abnormal brain connectivity involving the frontal and parieto-temporo-occipital lobes, as well as the thalamus.
The whole body F-18 FDG PET can be a potential tool to assess inflammatory process and support the hyperinflammatory etiology, mainly for lesions in skeletal muscle, vascular wall, and lung, as well as, multiple brain abnormalities in post-acute COVID-19. Nonetheless, further studies are recommended to confirm the results.
本研究旨在利用F-18 FDG PET/CT和PET/ rsfMRI脑成像技术,调查与急性后COVID-19相关的成像异常。
我们回顾性招募了13例急性后COVID-19患者。在进行F-18 FDG PET/CT全身及PET/rsfMRI脑成像之前,对急性后COVID-19症状和神经精神测试进行了评估。还对全身和脑部图像进行了定性和半定量分析。
13例患者中,8例(61.5%)患有肌炎,其次是8例(61.5%)患有血管炎(主要在胸主动脉),7例(53.8%)有肺部异常。有趣的是,1例血清RBD IgG抗体水平非常高的患者表现出全身弥漫性肌炎,这可能与免疫介导的肌炎有关。1例患者在COVID-19后出现银屑病加重,由自身免疫介导。大多数患者有多个脑连接异常区域,涉及额叶、顶颞枕叶以及丘脑。
全身F-18 FDG PET可能是评估炎症过程和支持炎症病因学的潜在工具,主要用于评估急性后COVID-19患者骨骼肌、血管壁和肺部的病变以及多个脑部异常。尽管如此,建议进一步研究以证实结果。