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Predictive value of 18F-FDG PET/CT in patients with acute type B aortic intramural hematoma

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

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.

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Abbreviations

AAS:

Acute aortic syndrome

CTA:

Computed tomography angiography

18F-FDG:

18F-fluorodeoxyglucose

IMH:

Intramural hematoma

PAU:

Penetrating aortic ulcer

PET/CT:

Positron emission tomography/computed tomography

SUV:

Standardized uptake value

TBR:

Target to blood ratio

TEVAR:

Thoracic endovascular repair

ULP:

Ulcer-like projection

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Disclosure

No grants, contracts, or any other forms of financial support were involved in this study. There was no relationship between this study and any industry.

Author information

Authors and Affiliations

  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

    Fan Yang MD, Jianfang Luo MD, Nianjin Xie MD, Wenhui Huang MD, Yuan Liu MD, Yingling Zhou MD, Jiyan Chen MD & Qingshan Geng MD

  2. Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Qingyi Hou MD

  3. Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Zhiqiang Nie MD

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  1. Fan Yang MD
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Correspondence to Jianfang Luo MD.

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Yang, F., Luo, J., Hou, Q. et al. Predictive value of 18F-FDG PET/CT in patients with acute type B aortic intramural hematoma. J. Nucl. Cardiol. 26, 633–641 (2019). https://doi.org/10.1007/s12350-017-1014-9

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  • DOI: https://doi.org/10.1007/s12350-017-1014-9

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