Heras-Recuero Elena, Landaeta-Kancev Laura Cristina, Martínez de Bourio-Allona Marta, Torres-Rosello Arantxa, Blázquez-Sánchez Teresa, Ferraz-Amaro Iván, Castañeda Santos, Martínez-López Juan Antonio, Martínez-Dhier Luis, Largo Raquel, González-Gay Miguel Ángel
Division of Rheumatology, IIS-Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040 Madrid, Spain.
Department of Nuclear Medicine, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain.
J Clin Med. 2023 Sep 24;12(19):6164. doi: 10.3390/jcm12196164.
(1) Objective:To assess the spectrum of PET-CT-related large vessel vasculitis (LVV) in a Spanish tertiary center and to determine whether FDG uptake by PET-CT differs between giant cell arteritis (GCA) with predominant cranial or extracranial phenotypes. (2) Methods: The spectrum of patients diagnosed with LVV by PET-CT in a tertiary referral hospital that cares for 450,000 people over a period of two years was reviewed. Moreover, differences in FDG uptake between LVV-GCA with predominantly cranial and extracranial phenotype were analyzed. (3) Results: Eighty patients were diagnosed with LVV by PET-CT. Most were due to systemic vasculitis ( = 64; 80%), especially GCA ( = 54; 67.5%). Other conditions included the presence of rheumatic diseases ( = 4; 3.2%), tumors ( = 9; 7.2%) and infections ( = 3; 2.4%). LVV-GCA patients with predominant extracranial GCA phenotype were younger (mean ± SD: 68.07 ± 9.91 vs. 75.46 ± 7.64 years; = 0.017) and had a longer delay to the diagnosis (median [interquartile range] 12 [4-18] vs. 4 [3-8]; = 0.006), but had polymyalgia rheumatica symptoms more frequently than those with predominantly cranial GCA phenotype (46.3% vs. 15.4%, = 0.057). When FDG uptake was compared according to the two different disease patterns, no statistically significant differences were observed. However, patients with extracranial LVV-GCA showed a non-significantly higher frequency of vasculitic involvement of lower-extremity arteries. (4) Conclusions: Regardless of the predominant phenotype, LVV identified by PET-CT is more commonly due to GCA in the Spanish population. In these GCA patients, younger age, PMR, and a higher frequency of lower-extremity artery vasculitis suggest the presence of LVV.
(1) 目的：评估西班牙一家三级医疗中心PET-CT相关的大血管血管炎（LVV）的谱型，并确定PET-CT检测到的氟脱氧葡萄糖（FDG）摄取在以颅部或颅外表型为主的巨细胞动脉炎（GCA）之间是否存在差异。(2) 方法：回顾了一家为45万人提供医疗服务的三级转诊医院在两年内通过PET-CT诊断为LVV的患者谱型。此外，分析了以颅部和颅外表型为主的LVV-GCA之间FDG摄取的差异。(3) 结果：80例患者通过PET-CT诊断为LVV。大多数病因是系统性血管炎（n = 64；80%），尤其是GCA（n = 54；67.5%）。其他情况包括存在风湿性疾病（n = 4；3.2%）、肿瘤（n = 9；7.2%）和感染（n = 3；2.4%）。以颅外表型为主的LVV-GCA患者更年轻（平均±标准差：68.07±9.91岁 vs. 75.46±7.64岁；P = 0.017），诊断延迟时间更长（中位数[四分位间距]12[4 - 18] vs. 4[3 - 8]；P = 0.006），但与以颅部表型为主的GCA患者相比，出现风湿性多肌痛症状的频率更高（46.3% vs. 15.4%，P = 0.057）。根据两种不同疾病模式比较FDG摄取时，未观察到统计学上的显著差异。然而，颅外LVV-GCA患者下肢动脉血管炎累及频率略高，但无统计学意义。(4) 结论：在西班牙人群中，无论主要表型如何，PET-CT检测到的LVV更常见的病因是GCA。在这些GCA患者中，年龄较小、出现风湿性多肌痛以及下肢动脉血管炎频率较高提示存在LVV。
