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Heart (British Cardiac Society) Feb 2024
Topics: Humans; Young Adult; Ventricular Dysfunction, Left; Cardiomyopathy, Dilated
PubMed: 38346774
DOI: 10.1136/heartjnl-2023-323471 -
Mediterranean Journal of Rheumatology Mar 2024
PubMed: 38736959
DOI: 10.31138/mjr.231020.nht -
European Heart Journal Sep 2023
Topics: Humans; Aortitis; Anti-Bacterial Agents; Blood Vessel Prosthesis; Emphysema
PubMed: 37525553
DOI: 10.1093/eurheartj/ehad474 -
Neurology Nov 2023
Topics: Humans; Aortitis; Granulomatosis with Polyangiitis; Meningitis
PubMed: 37652705
DOI: 10.1212/WNL.0000000000207762 -
Clinical Radiology Jun 2024To evaluate the diagnostic performance of 2-[F]-fluoro-2-deoxy-d-glucose (F-FDG) positron-emission tomography (PET)/computed tomography (CT) in TA diagnosis and Takayasu...
AIM
To evaluate the diagnostic performance of 2-[F]-fluoro-2-deoxy-d-glucose (F-FDG) positron-emission tomography (PET)/computed tomography (CT) in TA diagnosis and Takayasu arteritis (TA) activity assessment.
MATERIALS AND METHODS
This retrospective study included patients with TA diagnosed according to the American College of Rheumatology (ACR) criteria and undergoing F-FDG PET/CT imaging from October 2010 to July 2022. TA activity was assessed through F-FDG PET/CT (maximum standard uptake value [SUVmax], vascular SUVmax/mean standard uptake value [SUVmean] of liver (SUV ratio), and PET vascular activity score [PETVAS]) using physician global assessment (PGA) as the reference standard, and the results of these assessments were compared against the clinical activity scores (National Institutes of Health [NIH] and Indian Aortitis Disease Activity [ITAS-A] scores), acute-phase reactants (APR), and white blood cell and platelet counts.
RESULTS
Twenty F-FDG PET/CT examinations from 19 patients were included in the study, nine were performed in the active phase and 11 in the inactive phase. The involved vessels showed segmental and tubular FDG uptake in the active group. The average SUVmax, SUV ratio, and PETVAS was 6.3 ± 2.7 (range 3.4-12), 4.2 ± 1.7 (range 2.1-7.5), and 22.7 ± 11.2 (range 6-39), respectively, in the active group and 1.7 ± 0.9 (0.9-3.1), 1.1 ± 0.6 (range 0.6-2.4), and 3.5 ± 5.5 (range 0-18), respectively, in the inactive group. The sensitivity, specificity of SUVmax, SUV ratio, and PETVAS for TA activity assessment were 100%, 100%; 100%, 90.9%; and 88.9, 90.9%, respectively. After ROC curve analysis, a new SUVmax cut-off was obtained. Based on the new cut-off value, SUVmax 3.3 and SUV ratio 1.9 had a more perfect assessment performance.
CONCLUSION
F-FDG PET/CT is an alternative imaging technique for TA.
Topics: Humans; Takayasu Arteritis; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Female; Retrospective Studies; Radiopharmaceuticals; Male; Adult; Middle Aged; Young Adult; Adolescent; Sensitivity and Specificity
PubMed: 38492999
DOI: 10.1016/j.crad.2024.01.020 -
BMJ Case Reports Mar 2024Infectious aortitis is a rare disease process which can be of fungal, viral or bacterial aetiology. This disease process is often incidentally found during concomitant...
Infectious aortitis is a rare disease process which can be of fungal, viral or bacterial aetiology. This disease process is often incidentally found during concomitant infectious processes, likely due to haematogenous spread. Common sources are from cardiac, genitourinary and gastroenterologic sources. CT imaging of the aorta is essential in identifying physiological changes-wall thickness changes, ectasia and stenosis. We present a case of a female in her early 60s with a medical history of cardiomyopathy with heart failure and reduced ejection fraction, who was initially admitted for acute cholecystitis complicated by the development of gallstone pancreatitis. Imaging evaluation incidentally noted findings consistent with aortitis with a penetrating ulcer, and blood cultures were positive for bacteraemia, confirming her diagnosis of infectious aortitis. She was started on intravenous antibiotics, required preoperative nutritional optimisation, and subsequently underwent an open aortic resection and aortoiliac reconstruction with rifampin-soaked Dacron graft.
Topics: United States; Humans; Female; Aortitis; Bacteremia; Hospitals, Military; Staphylococcal Infections; Staphylococcus aureus; Soft Tissue Infections
PubMed: 38538095
DOI: 10.1136/bcr-2023-257509 -
Clinical Nuclear Medicine Dec 2023To elucidate the PET/CT findings of pegfilgrastim-induced aortitis (PFIA) and compare them with those of other large-vessel vasculitis. (Observational Study)
Observational Study
PURPOSE OF THE REPORT
To elucidate the PET/CT findings of pegfilgrastim-induced aortitis (PFIA) and compare them with those of other large-vessel vasculitis.
METHODS
We enrolled 45 patients diagnosed with the following: PFIA, n = 8; Takayasu arteritis (TA), n = 12; giant cell arteritis (GCA), n = 6; and immunoglobulin G4-related aortitis (IgG4-A), n = 19. Records of PET/CT performed before treatment initiation were collected. The aorta and its branches were divided into 16 anatomic regions. Presence of abnormal 18 F-FDG uptake in each region was determined and measured.
RESULTS
The 18 F-FDG-positive areas of PFIA were distributed in the regions of the ascending aorta to the suprarenal abdominal aorta, cervical branches of the aorta, and external iliac arteries, similar to those of TA. However, TA had a higher proportion of 18 F-FDG-positive areas than PFIA in almost all anatomic regions. These areas of GCA were widespread throughout the entire aorta and the upper and lower limbs, whereas those of IgG4-A were observed from the abdominal aorta to iliac arteries. SUV max , SUV peak , metabolic volume, and total lesion glycolysis were higher in GCA than in PFIA, TA, and IgG4-A.
CONCLUSIONS
Pegfilgrastim-induced aortitis distribution on PET/CT was frequently observed in the aorta, cervical branches, and extra iliac arteries. The low proportion of 18 F-FDG-positive areas in PFIA was different from that of TA, GCA, and IgG4-A. These findings may help identify and differentiate various aortitis types in clinical practice.
Topics: Humans; Aortitis; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Giant Cell Arteritis; Takayasu Arteritis; Aorta, Abdominal; Immunoglobulin G
PubMed: 37703494
DOI: 10.1097/RLU.0000000000004847 -
Radiology Case Reports Oct 2023Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive...
Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive plasma cells toward several organs. Coronary artery involvement is rarely seen in IgG4-RD patients; thereby, we aim to outline the noninvasive imaging findings of this rare case. Cardiac magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) from a 15-year-old female diagnosed with IgG4-RD via histopathological assessment of orbital biopsy, were analyzed. CMR showed a severely reduced left ventricular ejection fraction and akinesia of the basal to mid-lateral, anterior, and septal walls. Inflammation of the basal to apical lateral wall and subendocardial infarction of the basal to apical lateral and mid inferoseptal walls were also evident. CCTA findings showed stenosis in branches of the left main artery (LM), left anterior descending artery (LAD), and right coronary artery (RCA), aortitis, and aortic wall thickening. After courses of proper treatment with prednisolone, Cellcept, and adalimumab, follow-up CMR showed significant improvement in LV systolic function and resolution of inflammation. Although IgG4-RD is an uncommon cause of coronary artery disease, it can cause lethal complications such as myocardial infarction. Hence, clinicians should be aware of cardiac complications in these patients.
PubMed: 37609068
DOI: 10.1016/j.radcr.2023.07.062 -
International Journal of Infectious... Jan 2024
Topics: Humans; Campylobacter fetus; Aortitis; Myocarditis; Campylobacter Infections; Bacteremia; Soft Tissue Infections
PubMed: 38016501
DOI: 10.1016/j.ijid.2023.11.033 -
JACC. Case Reports Aug 2023Infectious aortitis is a rare but devastating vascular infection with mortality exceeding 40%. Early diagnosis is crucial but often hampered by radiographic mimickers....
Infectious aortitis is a rare but devastating vascular infection with mortality exceeding 40%. Early diagnosis is crucial but often hampered by radiographic mimickers. We report a patient who was thought to have lung cancer but ultimately found to have an infected aortic aneurysm and bacteremia owing to species. Owing to surgical contraindications, he was treated palliatively with an initial regimen of intravenous ampicillin/sulbactam followed by lifelong oral antibiotic suppression. He ultimately rejected his diagnosis, discontinued medications, and was lost to follow-up. ().
PubMed: 37614331
DOI: 10.1016/j.jaccas.2023.101943