摘要
目的 探讨18F-脱氧葡萄糖(FDG) PET/CT在抗中性粒细胞胞质抗体相关性血管炎(AAV)中的临床应用价值。 方法 回顾性分析2015年1月至2017年6月15例[男7例,女8例,年龄(66±11)岁]确诊的AAV患者资料,包括6例肉芽肿性多血管炎(GPA)、7例显微镜下多血管炎(MPA)和2例嗜酸性肉芽肿性多血管炎(EGPA)。观察和记录18F-FDG PET/CT所示疾病累及范围、影像特征以及病变的最大标准摄取值(SUVmax)。对病变SUVmax与患者同时期C反应蛋白(CRP)进行Pearson相关分析,并采用两样本t检验比较CRP升高组与正常组的病变SUVmax和累及范围的差异。 结果 15例AAV患者中14例PET/CT显像阳性,共56个病灶。累及15个部位:耳鼻喉区与肺各9例,肾脏8例,脾与淋巴结各6例,骨髓4例,皮肤3例,前列腺、主动脉与椎体前缘软组织灶各2例,眼眶、腮腺、甲状腺、肝与胰腺各1例。34个病灶(60.7%,34/56)为临床评估时未怀疑到的隐匿病灶。GPA病变主要累及耳鼻喉区、肺和肾脏,MPA主要累及肾脏和脾,EGPA主要累及耳鼻喉区、淋巴结和骨髓。患者的CRP水平与病灶的SUVmax无相关性(r=0.462,P>0.05),CRP升高组病灶与CRP正常组SUVmax差异亦无统计学意义(t=1.451,P>0.05),但CRP升高组的受累部位明显多于CRP正常组(t=3.456,P<0.05)。 结论 18F-FDG PET/CT在AAV中能检出很多阳性灶,尤其可发现临床隐匿病灶,可作为AAV辅助诊断的重要检查手段,评估病变程度及全身累及范围。
Objective To explore the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT in assessing antineutrophil cytoplasmic antibody-associated vasculitis (AAV).Methods Fifteen patients(7 males, 8 females, age (66±11) years) with AAV between January 2015 and June 2017 were retrospectively analyzed. There were 6 patients diagnosed as granulomatosis with polyangiitis (GPA), 7 diagnosed as microscopic polyangiitis (MPA) and 2 diagnosed as eosinophilic granulomatosis with polyangiitis (EGPA). All patients underwent 18F-FDG PET/CT and the image features were observed and analyzed. The maximum standardized uptake value (SUVmax) of the positive lesion was measured. The relationship between the SUVmax and C reactive protein (CRP) was analyzed with Pearson correlation. The SUVmax and the number of lesion sites were compared by two-sample t test between the CRP-elevated and CRP-normal patients.Results A total of 56 lesions in the 14 of 15 AAV patients were detected by PET/CT. The positive findings distributed in 15 tissues and organs, including the nasopharynxes (n=9), lungs (n=9), kidneys (n=8), spleen (n=6), lymph nodes (n=6), bone marrow (n=4), skin (n=3), prostate (n=2), aortas (n=2), vertebral soft tissues (n=2), orbita (n=1), parotid gland (n=1), thyroid gland (n=1), liver (n=1) and pancreas (n=1). The 60.7% (34/56) of lesions were clinically unsuspected occult lesions. GPA lesions mainly invaded the nasopharynxes, lungs and kidneys;MPA lesions mainly invaded the kidneys and spleen;EGPA lesions mainly invaded the nasopharynxes, lymph nodes and bone marrow. There was no significant correlation between the level of CRP and the SUVmax of AAV lesions (r=0.462, P>0.05). No differences in the SUVmax were observed between patients with elevated CRP levels and those with normal CRP levels (t=1.451, P>0.05). But more lesion sites were observed in patients with elevated CRP (t=3.456, P<0.05).Conclusions 18F-FDG PET/CT shows positive findings in multiple sites in AAV patients, including clinically unsuspected sites. This imaging technique may be a useful tool for diagnosis and evaluation of AAV.
作者
陆东燕
俞浩楠
李彦生
陈秋松
高硕
Lu Dongyan;Yu Haonan;Li Yansheng;Chen Qiusong;Gao Shuo(Department of PET/CT Diagnostic,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Nuclear Medicine,Tianjin First Center Hospital,Tianjin 300192,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2019年第2期91-95,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
