PRE-PULSELESS TAKAYASU'S ARTERITIS EVALUATED WITH …



PRE-PULSELESS TAKAYASU'S ARTERITIS EVALUATED WITH POSITRON EMISSION TOMOGRAPHY & MAGNETIC RESONANCE

R. Calleja1, A. Martinez1, P.A. Lamothe1, A. Meave1, 2, M.E. Soto2, P. Reyes2,

E. Alexanderson1,2

1PET/CT Cyclotron Unit, Facultad de Medicina. Universidad Nacional Autonoma de Mexico, 2Instituto Nacional de Cardiologia Ignacio Chavez, Mexico

Objective: Demonstrate the usefulness of non-invasive methods, positron emission tomography (PET) and magnetic resonance angiography (MRA) in the assessments of inflammatory activity in patients with Takayasu’s Arteritis (TA) Background TA is a primary vasculitis that affects large vessels. Diagnosis is made primarily clinical, with verification by invasive angiograph. More recently, it has become apparent that PET and gadolinium-enhanced MRA enable better assessment of vascular inflammation in these patients.

Methods: This study presents 2 cases of TA. MRA was used to evaluate vessel anatomy by analyzing vascular wall thickness and quantifying activity by measuring gadolinium enhancement. PET was used to evaluate vascular inflammation by quantifying fluorodeoxyglucose F18 (18F-FDG) uptake. 18F-FDG uptake was quantified using the standard uptake value (SUV) defined as a tissue activity concentration divided by the total activity injected per body weight.

Results: Patient 1: MRA image showed a thick aortic wall (4 mm); revealed an irregular vascular wall, progressive occlusions of the descending aorta and left subclavian artery. Endovascular exploration also revealed pseudoaneurysm formation. PET showed increased uptake (2.7 SUV) of 18F-FDG in the aortic arch. Patient 2: MRA imaging sequences showed occlusion of the left subclavian artery and of the aortic arch. The MRA images also revealed a 7-mm perivascular thickening of the thoracic aorta. PET revealed an 18F-FDG SUV of 4.5 at the aortic arch.

Conclusions: although, 18F-FDG PET can truly quantify inflammation by analyzing the glucose based tracer uptake in the vascular lesions, MRA is also an accurate technique. Both methods are complementary in the non-invasive analysis of vascular lesion in patients with TA.

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