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Recent studies on the role of viable myocardium in revascularization are hot spots.The definition of viable myocardium,multimodality imaging in the assessment of myocardial viability,Meta analyses related to the value of viable myocardium in revascularization,prospective randomized trials,and factors affecting the prognosis of patients after revascularization are reviewed in this article.
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Objective To investigate the characteristics of 18F-FDG PET/CT imaging in Takayasu arteritis (TA) and its clinical value.Methods Five male patients with TA in active phase (age range:65-82 years;mean age:(72.8±6.6) years) from November 2011 to August 2014 were retrospectively analyzed.All patients underwent 18F-FDG PET/CT imaging,and one of them who was in stable phase after one year's treatment underwent follow-up PET/CT imaging.The characteristics of the abnormal 18F-FDG uptake and SUVmax of lesions were analyzed.Another 5 age-and gender-matched patients with slightly elevated tumor markers and normal results of 18F-FDG PET/CT imaging in the same period were selected as the control group.Arteries were divided into 18 segments,including the ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right common carotid,the left/right subclavian,the left/right brachial,the superior mesenteric,the left/right common iliac,the left/right renal,and the left/right femoral,and their SUVmax were measured respectively.Paired t test was used to analyze the difference of SUVmax between TA group and the control group.Results (1) 18 F-FDG PET/CT imaging displayed diffused increase of radioactivity in the wall of aorta and its major branches in TA group,and CT showed multiple irregular thickening,punctate and banding calcification in arterial walls of those patients.The ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right subclavian,the left/right common carotid,and the left/right common iliac artery were all involved in 5 patients;the left/right brachial and the left/right femoral artery were involved in 4 patients and the superior mesenteric artery was involved in 2 cases.The SUVmax range was 1.4-7.6,the highest SUVmax was in the left subclavian artery (n=2),the right subclavian artery (n=1) and the abdominal aorta artery (n=2).(2)The SUVmax of TA group and the control group were 3.96±1.35 and 2.13±0.53,respectively(t=10.40,P＜0.001).(3) As to the TA patient in stable phase after treatment,the FDG uptake of the wall of aorta and its major branches decreased obviously compared with that before treatment.The SUVmax of left subclavian artery decreased from 6.8 to 3.2.Conclusions 18F-FDG PET/CT is helpful in diagnosis of TA.It could accurately display the range of involved arteries,reflect the activity of the lesion and evaluate the therapeutic response.
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PurposeCurrent conventional imaging methods X-ray, CT, MRI and ultrasound for rheumatic diseases are mostly local site imaging, rather than systemic display, thus is difficult to show the whole picture of the diseases, this study aims to explore the18F-FDG PET/CT findings of rheumatic diseases and its preliminary clinical value. Materials and Methods18F-FDG PET/CT imaging findings and clinical data of 18 patients with rheumatic diseases confirmed by clinical diagnosis were retrospectively analyzed, and 18F-FDG uptake of lesions was observed.Results Among all the 18 patients with rheumatic diseases: four cases were with rheumatoid arthritis (RA), 5 cases with takayasu arteritis (TA), 2 cases with adult onset Still’s disease (AOSD), 1 case with polymyalgia rheumatica (PMR) and 6 cases with ankylosing spondylitis (AS). Findings of PET/CT: RA showed increased FDG uptake in multiple bigger joints such as shoulder joint, elbow, hip, wrist joint, and part palm finger joints, with no bone abnormalities in CT; TA displayed as diffusely increased uptake of FDG the aorta and its major branches vascular wall while CT showed multiple arterial wall irregular thickening with dot or strip calcification, and in one case, the vascular wall FDG uptake decreased obviously after one year treatment, the SUVmax of left clavicle dropped from 6.8 to 3.2; AOSD showed diffusely increased FDG uptake in spleen and bone marrow, while CT had no obvious spleen and bone abnormalities; PMR showed increased uptake of FDG in the atlantoaxial joint, shoulder joint, sternoclavicular joint, hip joint, pubic symphysis, ischial tuberosity and lesions around lumbar spinous process; only 1 case of 6 AS patients showed left acetabular articular surface hyperplasia and sclerosis with increased FDG uptake, while CT showed spinal multiple vertebral bone hyperplasia and sclerosis as bamboo change in all of 6 AS cases, with normal FDG metabolism. Conclusion18F-FDG PET/CT is helpful for the diagnosis of rheumatic diseases, because it can be used to display the lesion extent, reflect its activity, and also to evaluate the effect of the treatments.