Katakura Tokio, Shirai Tsuyoshi
Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan.
J Clin Med. 2025 Apr 24;14(9):2939. doi: 10.3390/jcm14092939.
Takayasu arteritis (TAK) is a rare, chronic large-vessel vasculitis that predominantly affects the aorta and its major branches. Early and accurate diagnosis remains essential to prevent irreversible vascular damage and organ dysfunction. Positron emission tomography/computed tomography (PET/CT) has emerged as a valuable imaging modality for detecting active vascular inflammation in TAK. Using 18F-fluorodeoxyglucose (18F-FDG), PET/CT enables the assessment of metabolic activity in inflamed arterial walls, supporting both initial diagnosis and disease monitoring. Compared with conventional imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), PET/CT provides functional data correlated with inflammatory activity rather than solely anatomical changes. Recent studies have highlighted its utility in distinguishing active from chronic disease, predicting relapse, and evaluating treatment response. This review summarizes the role of PET/CT in TAK, addressing its advantages, patterns of vascular involvement, limitations, and future perspectives. Vascular lesions identified using PET/CT do not always align with those detected by other imaging modalities, with PET/CT demonstrating superiority in revealing aortic inflammation potentially overlooked by alternative techniques. Further research is needed to establish whether PET/CT-based vascular involvement patterns, rather than conventional angiographic findings, can help identify disease subtypes of TAK.
高安动脉炎（TAK）是一种罕见的慢性大血管血管炎，主要累及主动脉及其主要分支。早期准确诊断对于预防不可逆的血管损伤和器官功能障碍仍然至关重要。正电子发射断层扫描/计算机断层扫描（PET/CT）已成为检测TAK中活动性血管炎症的一种有价值的成像方式。PET/CT使用18F-氟脱氧葡萄糖（18F-FDG），能够评估炎症动脉壁的代谢活性，有助于初始诊断和疾病监测。与传统成像技术如磁共振成像（MRI）和计算机断层扫描（CT）相比，PET/CT提供与炎症活动相关的功能数据，而不仅仅是解剖学变化。最近的研究突出了其在区分活动期与慢性期疾病、预测复发以及评估治疗反应方面的效用。本综述总结了PET/CT在TAK中的作用，阐述了其优势、血管受累模式、局限性及未来展望。使用PET/CT识别的血管病变并不总是与其他成像方式检测到的病变一致，PET/CT在揭示可能被其他技术忽视的主动脉炎症方面显示出优势。需要进一步研究以确定基于PET/CT的血管受累模式而非传统血管造影结果是否有助于识别TAK的疾病亚型。
