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題 名 | Takayasu Arteritis Detected by F-18 FDGPET/CT=正子斷層造影發現的高安氏動脈炎 |
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作 者 | 林聖哲; 黃建賢; 陳世緯; 陳遠光; | 書刊名 | Annals of Nuclear Medicine and Molecular Imaging |
卷 期 | 36:4 2023.12[民112.12] |
頁 次 | 頁177-181 |
分類號 | 415.2167 |
關鍵詞 | 氟18去氧葡萄糖正子斷層造影; 高安氏動脈炎; 巨細胞動脈炎; 中風; F-18 FDG PET/CT; Stroke; Takayasu arteritis; |
語 文 | 英文(English) |
DOI | 10.6332/ANMMI.202312_36(4).0007 |
中文摘要 | 一名68歲男性自2020年6月開始左側肢無力。腦部電腦斷層顯示右側基底節急性缺血,左鎖骨下動脈近端和右顱內動脈近端狹窄。另發現肝功能異常,被視為藥物引起的肝功能衰竭。治療後肝功能逐漸恢復正常。入院後,進行了正子電腦斷層掃描(positron emission tomography/computed tomography, PET/CT),結果顯示主動脈、頸動脈和鎖骨下動脈的葡萄糖攝取增加。疑似為巨細胞動脈炎。然而,患者在次日洗冷水澡後突然出現言語不清伴面神經麻痺。腦部電腦斷層血管造影顯示(computed tomography angiography, CTA)顯示右側基底節(basal ganglia, BG)缺血,左側鎖骨下動脈近端中度狹窄,右側頸內動脈近端(internal carotid artery, ICA)嚴重狹窄。處方了抗血小板治療。晚間多次突發言語不清、運動性失語,經治療兩週後病情好轉,再無神經症狀。鑑於患者是日本人的子嗣,我們安排了主動脈電腦斷層,結果顯示大血管受累伴開口附近副動脈多灶性短段狹窄,較符合高安動脈炎。由於高度懷疑高安動脈炎,最初使用大劑量類固醇。之後沒有提到具體的不適。隨後他在相對穩定的情況下出院。在完成氟18葡萄糖正子電腦斷層掃描後我們知道患者可能是某種大血管炎,氟18葡萄糖正子電腦斷層掃描在大血管血管炎(large vessel vasculitis, LVV)患者顱外血管的診斷中具有重要作用。 |
英文摘要 | A 68-year-old male suffered from left-side weakness two weeks ago. The brain computed tomography (CT) showed acute ischemic infarction of the right basal ganglia, stenosis of the left proximal subclavian artery, and right proximal intracranial artery. A liver function abnormality was found. He was treated for drug-induced liver failure. The liver function is gradually normal after the drug was discontinued. After admission, due to suspecting of urinary tract infection the positron emission tomography/computed tomography (PET/CT) scan was done and showed increased FDG uptake in the aorta, carotid, and subclavian arteries. The impression is vasculitis. However, the sudden onset of slurred speech with facial palsy was noticed the next day. The brain CT and CT angiography showed right basal ganglia infarction with moderate stenosis of the left proximal subclavian artery and severe stenosis of the right proximal internal carotid artery. The antiplatelet therapy was prescribed. Many times of sudden onset slurred speech and motor aphasia in the evening, till his condition improved after two weeks of treatment, and no more neurological symptoms were observed. After we know the patient is a Japanese descendant, we arranged an aorta CT for suspecting Takayasu arteritis (TAK), and the result showed large vessel involvement with multifocal short-segment stenosis of visceral arteries near the ostium, compatible with TAK. Due to highly suspected TAK, a high-dose steroid was used. No specific discomfort was mentioned after that. In this case, we know the patient has some kind of large vessel inflammation after the FDG-PET/CT was done. FDG-PET/CT has an important role in the diagnosis of extracranial vascular involvement in patients with large vessel vasculitis. |
本系統中英文摘要資訊取自各篇刊載內容。