Suzuki Asuka, Hayashi Koji, Sato Mamiko, Nakaya Yuka, Miura Toyoaki, Takaku Naoko, Iwasaki Toshiko, Kobayashi Yasutaka
Department of Rehabilitation Medicine, Fukui General Hospital, 55-16-1 Egami-cho, Fukui 910-8561, Japan.
Graduate School of Health Science, Fukui Health Science University, 55-13-1 Egami, Fukui 910-3190, Japan.
Diagnostics (Basel). 2025 Apr 30;15(9):1151. doi: 10.3390/diagnostics15091151.
A 75-year-old man, with a history of descending thoracic aortic rupture and dissection treated with aortic stenting at 73 years old, was admitted for rehabilitation following recurrent cerebral ischemic attacks. Upon admission, blood tests revealed elevated inflammatory markers, including a C-reactive protein (CRP) level of 10.75 mg/dL and a D-dimer level of 4.2 µg/mL, alongside microcytic anemia. Despite thorough evaluations using computed tomography (CT) and ultrasound, the origin of these abnormalities remained unidentified. Two months later, MRI using diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) revealed hyperintensities in the thoracic aorta. He remained asymptomatic and progressed well during rehabilitation, prompting continued observation. However, three months after admission, he developed hemoptysis. Contrast-enhanced CT showed pneumonia, as well as enhanced lesions in the aortic wall, confirming aortic inflammation. Due to concerns about aortic stent ulceration, an emergency stent graft insertion extending to the superior mesenteric artery was performed. He recovered uneventfully and was discharged. DWIBS is an MRI-based tool that avoids exposure to radiation or contrast agents and is cost-effective. MRI using DWIBS demonstrated high signal accumulations in the aortic wall, indicative of inflammation. These findings suggest that DWIBS holds significant potential as a powerful imaging tool for detecting and assessing inflammation, particularly in the aorta.
一名75岁男性，有降主动脉破裂和夹层病史，73岁时接受了主动脉支架置入治疗，因反复发生脑缺血发作入院进行康复治疗。入院时，血液检查显示炎症标志物升高，包括C反应蛋白（CRP）水平为10.75mg/dL，D-二聚体水平为4.2μg/mL，同时伴有小细胞贫血。尽管使用计算机断层扫描（CT）和超声进行了全面评估，但这些异常的起源仍未确定。两个月后，采用背景体信号抑制扩散加权全身成像（DWIBS）的MRI显示胸主动脉有高信号。他在康复期间一直无症状且进展良好，因此继续观察。然而，入院三个月后，他出现了咯血。增强CT显示有肺炎以及主动脉壁强化病变，证实存在主动脉炎症。由于担心主动脉支架溃疡，遂紧急进行了延伸至肠系膜上动脉的支架移植物置入术。他恢复顺利并出院。DWIBS是一种基于MRI的工具，可避免暴露于辐射或造影剂，且具有成本效益。使用DWIBS的MRI显示主动脉壁有高信号积聚，提示存在炎症。这些发现表明，DWIBS作为一种强大的成像工具，在检测和评估炎症方面，尤其是在主动脉炎症方面，具有巨大潜力。
