Fan Yang1, Jianfang Luo2, Qingyi Hou3, Nianjin Xie1, Zhiqiang Nie4, Wenhui Huang1, Yuan Liu1, Yingling Zhou1, Jiyan Chen1, Qingshan Geng1. 1. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, No. 96, Dongchuan Road, Guangzhou, 510100, Guangdong, China. 2. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, No. 96, Dongchuan Road, Guangzhou, 510100, Guangdong, China. jianfangluo@sina.com. 3. Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 4. Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Abstract
BACKGROUND: The clinical course and predictors of adverse aortic events (AAE) in patients with acute Stanford type B intramural hematoma (IMH) remain controversial. This study aimed to investigate whether 18F-FDG PET/CT can predict risk in patients with acute type B IMH. METHODS AND RESULTS: This study included 34 patients with acute type B IMH who underwent PET/CT within 14 days from the onset of symptoms. The maximal standardized uptake values (SUVmax) of 18F-FDG uptake was significantly different between patients with or without AAE (4.3 ± 0.6 vs 3.7 ± 1.0, P = 0.020), but not the target to blood ratio (TBR, SUVmax divided by SUV in the superior vena cava) (1.6 ± 0.2 vs 1.5 ± 0.5, P = 0.064). In patients with initial ulcer-like projection (ULP), a blood-filled pouch protruding into the IMH, which was seen in 25 patients(74%), both the SUVmax and TBR were significantly higher in patients who developed AAE, (4.3 ± 0.6 vs 3.3 ± 0.5, P = 0.001; 1.6 ± 0.2 vs 1.4 ± 0.2, P = 0.01); the TBR >1.5, which is determined from receiver-operating-characteristic curve, had a sensitivity of 73% and a specificity of 80% in predicting AAE. CONCLUSION: Patients with ULP and high 18F-FDG uptake were more likely to develop AAE and may require closer surveillance with serial imaging.
BACKGROUND: The clinical course and predictors of adverse aortic events (AAE) in patients with acute Stanford type B intramural hematoma (IMH) remain controversial. This study aimed to investigate whether 18F-FDG PET/CT can predict risk in patients with acute type B IMH. METHODS AND RESULTS: This study included 34 patients with acute type B IMH who underwent PET/CT within 14 days from the onset of symptoms. The maximal standardized uptake values (SUVmax) of 18F-FDG uptake was significantly different between patients with or without AAE (4.3 ± 0.6 vs 3.7 ± 1.0, P = 0.020), but not the target to blood ratio (TBR, SUVmax divided by SUV in the superior vena cava) (1.6 ± 0.2 vs 1.5 ± 0.5, P = 0.064). In patients with initial ulcer-like projection (ULP), a blood-filled pouch protruding into the IMH, which was seen in 25 patients(74%), both the SUVmax and TBR were significantly higher in patients who developed AAE, (4.3 ± 0.6 vs 3.3 ± 0.5, P = 0.001; 1.6 ± 0.2 vs 1.4 ± 0.2, P = 0.01); the TBR >1.5, which is determined from receiver-operating-characteristic curve, had a sensitivity of 73% and a specificity of 80% in predicting AAE. CONCLUSION:Patients with ULP and high 18F-FDG uptake were more likely to develop AAE and may require closer surveillance with serial imaging.
Authors: Arturo Evangelista; Debabrata Mukherjee; Rajendra H Mehta; Patrick T O'Gara; Rossella Fattori; Jeanna V Cooper; Dean E Smith; Jae K Oh; Stuart Hutchison; Udo Sechtem; Eric M Isselbacher; Christoph A Nienaber; Linda A Pape; Kim A Eagle Journal: Circulation Date: 2005-02-14 Impact factor: 29.690
Authors: Yskert von Kodolitsch; Susanne K Csösz; Dietmar H Koschyk; Ilka Schalwat; Roger Loose; Matthias Karck; Christoph Dieckmann; Rossella Fattori; Axel Haverich; Jürgen Berger; Thomas Meinertz; Christoph A Nienaber Journal: Circulation Date: 2003-03-04 Impact factor: 29.690
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