Nienhuis Pieter H, van Sluis Joyce, van Snick Johannes H, Glaudemans Andor W J M, Meijering Sofie, Brouwer Elisabeth, Slart Riemer H J A
University of Groningen, University Medical Center Groningen, Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, 9713 GZ Groningen, The Netherlands.
Ommelander Hospital Groningen, Department of Internal Medicine, 9679 BJ Scheemda, The Netherlands.
Diagnostics (Basel). 2022 Nov 4;12(11):2694. doi: 10.3390/diagnostics12112694.
The clinical presentation of giant cell arteritis (GCA) is often nonspecific. Differentiating GCA from infectious, malignant, or other autoimmune pathology based on signs, symptoms, and laboratory parameters may therefore be difficult. Fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) imaging is an established tool in the diagnostic workup of GCA. An advantage of F-FDG-PET/CT is its ability to assist in the differential diagnosis by being able to demonstrate infection, inflammation, and malignancy when used in conjunction with clinical and laboratory data. Downsides to the use of F-FDG-PET/CT include its relatively low spatial resolution, associated radiation exposure, and the relatively long duration of imaging, causing limited availability and patient inconvenience. The advent of long axial field-of-view (LAFOV) PET/CT systems allows for PET imaging at a reduced imaging time or reduced tracer dose while maintaining high image quality. Here, we provide the first reported case of a patient with GCA and polymyalgia rheumatica (PMR) diagnosed using LAFOV PET/CT imaging. The patient presented in this case report had already been experiencing nonspecific symptoms for several years for which no cause was found. Lab investigations showed increased inflammatory parameters as well as persistent anemia. F-FDG LAFOV PET/CT attained high-quality images with clear signs of GCA and PMR even at 1 min of scan duration.
巨细胞动脉炎（GCA）的临床表现通常不具有特异性。因此，基于体征、症状和实验室参数来区分GCA与感染性、恶性或其他自身免疫性病变可能很困难。氟-18-氟脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）成像在GCA的诊断检查中是一种成熟的工具。F-FDG-PET/CT的一个优点是，当与临床和实验室数据结合使用时，它能够通过显示感染、炎症和恶性肿瘤来辅助进行鉴别诊断。使用F-FDG-PET/CT的缺点包括其相对较低的空间分辨率、相关的辐射暴露以及相对较长的成像时间，这导致其可用性有限且给患者带来不便。长轴视野（LAFOV）PET/CT系统的出现使得在保持高图像质量的同时，可以在缩短成像时间或减少示踪剂剂量的情况下进行PET成像。在此，我们报告首例使用LAFOV PET/CT成像诊断的GCA和风湿性多肌痛（PMR）患者。本病例报告中的患者已经出现非特异性症状数年，但未找到病因。实验室检查显示炎症参数升高以及持续性贫血。即使在扫描持续时间为1分钟时，F-FDG LAFOV PET/CT也获得了高质量图像，清晰显示出GCA和PMR的迹象。
