Review Article

The Role of 18F-FDG PET/CT in Large-Vessel Vasculitis: Appropriateness of Current Classification Criteria?

Figure 1

Patient history: lack of appetite and pain between the shoulder blades. Cardiologic evaluation and gastroscopy negative. CRP 224 mg/L. Increased 18F-FDG uptake in the aorta and its main branches and less intense FDG uptake in the distal abdominal aortic wall; corresponding CT slices show calcifications here. The mild increased perisynovial 18F-FDG uptake at both shoulders, which might be indicative of associated PMR. The increased 18F-FDG uptake at the pericardium is suggestive of pericarditis (white arrows). Note: patient had a carbohydrate restricted diet for 2 days before the 18F-FDG PET/CT investigation to decrease the 18F-FDG uptake in the myocardium. Patient had a TIA one year earlier and subsequent carotid artery desobstruction. LVV was not suspected at that time; no immunosuppressive therapy was given. After the diagnosis of LVV patient was in remission during 4 years with Prednisolon orally tapered from 10 to 7.5 and later 5 mg daily. Due to relapse Prednisolon was increased to 15 mg daily. Patient died 5 years after the diagnosis of LVV after a severe CVA.
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