Diagnosis and follow up of aortitis in the elderly

Ann Rheum Dis. 2004 Nov;63(11):1507-10. doi: 10.1136/ard.2003.015651.

Abstract

Objectives: To evaluate the correlation of MRI and [(18)F]FDG-PET scans with the clinical course and inflammatory markers in patients with aortitis.

Methods: Eight patients with aortitis presenting with unspecific GCA-like symptoms were examined. Aortitis was diagnosed and followed up by [(18)F]FDG-PET and MRI. The aorta was divided into three vascular regions (ascending aorta, aortic arch, and descending aorta) to localise the aortic inflammation and compare both imaging techniques.

Results: were correlated with clinical and laboratory examinations.

Results: At diagnosis, 20/24 vascular regions from eight patients were positive by [(18)F]FDG-PET scan and 15/21 aortic regions by MRI. Patients were treated with corticosteroids and followed up for a mean (SD) of 13.3 (4.7) months. In [(18)F]FDG-PET, 11/20 (55%) initially pathological aortic regions returned to normal in the follow up examination, which correlated closely with the clinical and laboratory follow up examination. Conversely, in MRI, 14/15 initially affected vascular regions were unchanged.

Conclusions: [(18)F]FDG-PET and MRI are both effective techniques for detecting early aortitis and have a high correlation with laboratory inflammatory measures. However, during the follow up examination, [(18)F]FDG-PET uptake decreased in line with the clinical symptoms and inflammatory serum markers, whereas MRI scans gave more static results.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aorta / diagnostic imaging
  • Aorta / pathology
  • Aortitis / diagnosis*
  • Aortitis / diagnostic imaging
  • Aortitis / drug therapy*
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Retrospective Studies

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • C-Reactive Protein