van Leer Bram, van Snick Johannes H, Londema Mark, Nijsten Maarten W N, Kasalak Ömer, Slart Riemer H J A, Glaudemans Andor W J M, Pillay Janesh
Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Critical Care, University Medical Center Groningen, University of Groningen, TA29, PO box: 30 001, 9700 RB Groningen, The Netherlands.
Clin Transl Imaging. 2023;11(3):297-306. doi: 10.1007/s40336-023-00550-y. Epub 2023 Mar 12.
We report the findings of four critically ill patients who underwent an [F]FDG-PET/CT because of persistent inflammation during the late phase of their COVID-19.
Four mechanically ventilated patients with COVID-19 were retrospectively discussed in a research group to evaluate the added value of [F]FDG-PET/CT.
Although pulmonary PET/CT findings differed, bilateral lung anomalies could explain the increased CRP and leukocytes in all patients. This underscores the limited ability of the routine laboratory to discriminate inflammation from secondary infections. Based on PET/CT findings, a secondary infection/inflammatory focus was suspected in two patients (pancreatitis and gastritis). Lymphadenopathy was present in patients with a detectable SARS-CoV-2 viral load. Muscle uptake around the hips or shoulders was observed in all patients, possibly due to the process of heterotopic ossification.
This case series illustrates the diagnostic potential of [F]FDG-PET/CT imaging in critically ill patients with persistent COVID-19 for the identification of other causes of inflammation and demonstrates that this technique can be performed safely in mechanically ventilated critically ill patients.
我们报告了4例危重症患者的研究结果,这些患者在新型冠状病毒肺炎(COVID-19)后期因持续性炎症接受了[F]氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描([F]FDG-PET/CT)检查。
研究组对4例接受机械通气的COVID-19患者进行了回顾性讨论,以评估[F]FDG-PET/CT的附加价值。
尽管肺部PET/CT表现各异,但双侧肺部异常可解释所有患者中C反应蛋白(CRP)和白细胞升高的原因。这突出了常规实验室区分炎症与继发感染的能力有限。基于PET/CT结果,2例患者(胰腺炎和胃炎)疑似存在继发感染/炎症病灶。在可检测到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒载量的患者中出现了淋巴结病。在所有患者中均观察到髋部或肩部周围的肌肉摄取,这可能是由于异位骨化过程所致。
该病例系列说明了[F]FDG-PET/CT成像在患有持续性COVID-19的危重症患者中用于识别其他炎症原因的诊断潜力,并表明该技术可在接受机械通气的危重症患者中安全进行。