Abstract 15357: Detection of Aoritc Wall Inflammation in Patients With Acute Aortic Intramural Hematoma by 18F-Fluorodeoxyglucose Positoron Emission Tomography (FDG-PET)
Background: Elevated serological markers of inflammation were reported to be associated with adverse outcome in patients with acute aortic intramural hematoma (IMH). The combined anatomic and metabolic information of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has shown potential in the imaging of aortic wall instability and underlying inflammation in aortic disease. The present study aimed to investigate the clinical significance of FDG-PET in patients with IMH.
Methods: A total of consecutive 46 patients with acute aortic syndrome were admitted within 24 hours from the symptom onset between September 2013 and May 2014. Patients who had uncontrolled systemic inflammation or surgical site infection were excluded. FDG-PET of the body trunk and CT angiography of the entire aorta was performed in acute phase. The maximal SUV values (SUVmax) were assessed within aortic wall in the entire descending thoracic aorta, and segmentally analyzed in each slice at proximal descending aorta (PD), mid descending aorta (MD) and distal descending aorta (DD).
Results: Twenty-one patients (age: 71±13, male/female: 13/8) including 7 patients with classic aortic dissection (AD) and 14 patients with aortic intramural hematoma (IMH), were included in the final analysis. The SUVmax were significantly higher in patients with IMH than those with AD at entire descending thoracic aorta (3.29±0.48 vs 2.73±0.37, P=0.01). Besides, segmental analysis showed greater uptake of 18F-FDG in PD (3.08±0.42 vs 2.58±0.35, P=0.01) and DD (3.06±0.50 vs 2.49±0.48, P=0.02). However, the serological levels of C-reactive protein and D-dimer at the time of PET scan were similar between the groups.
Conclusions: FDG-PET revealed greater vessel wall inflammation in patients with IMH than AD patients. These results may suggest the different pathophysiology between AD and IMH.
Author Disclosures: T. Kitai: None. S. Kaji: None. A. Ohnishi: None. T. Koyama: None. M. Senda: None. Y. Furukawa: None.
- © 2014 by American Heart Association, Inc.