(Tissue PET) Vascular metabolic imaging and peripheral plasma biomarkers in the evolution of chronic aortic dissections

作者：Sakalihasan Natzi^*; Nienaber Christoph A; Hustinx Roland; Lovinfosse Pierre; El Hachemi Mounia; Cheramy Bien Jean Paul; Seidel Laurence; Lavigne Jean Paul; Quaniers Janine; Kerstenne Marie Ange; Courtois Audrey; Ooms Annie; Albert Adelin; Defraigne Jean Olivier; Michel Jean Baptiste

来源：European Heart Journal-Cardiovascular Imaging, 2015, 16(6): 626-633.

DOI：10.1093/ehjci/jeu283

• F-18-FDG
• PET/CT
• Type B dissections
• Plasmin
• D-dimers
• Platelet
• Thrombin

Aims Despite adequate medical management, dissection of the descending aorta (type B) may develop complications, including aneurysmal progression and eventually rupture. Partial false lumen thrombosis has been identified as a marker of adverse evolution in chronic dissection. The aim of this study was to test the ability of complementary information, provided by F-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) and peripheral biomarkers, to add pathophysiological significance and a prognostic value to morphological data.
Methods and results We explored serial aortic F-18-FDG uptake by PET/CT imaging and plasma biomarkers in a series of 23 patients with type B dissection to predict complications from initial data and to investigate potential associations with aneurysmal expansion during follow-up. Complications occurred in 17 patients. Acute initial characteristics associated with complications were male gender (P = 0.021), arterial hypertension (P = 0.040), aortic dissection diameter (P = 0.0086), partial thrombosis of the false channel (P = 0.0046), and enhanced focal 18F-FDG uptake (P = 0.045). During follow-up (mean 16.7 +/- 8.0 months), aneurysmal expansion was associated with false lumen morphology (P < 0.0001), quantitative F-18-FDG uptake, (P = 0.0029), elevated plasma concentrations of biomarkers of platelets (P-selectin, P = 0.0009) and thrombin activation (TAT complexes, P = 0.0075), and fibrinolysis (PAP complexes, P < 0.0001; D-dimers, P = 0.0006). Plasma markers of coagulation and fibrinolysis were related to false channel morphology, suggesting that thrombus biological dynamics may drive progressive expansion of type B dissections.
Conclusion Enhanced FDG uptake may be considered as a complementary imaging marker associated with secondary complications in type B dissections. During follow-up, aneurysmal progression is related to PET/CT and biomarkers of thrombus renewal and lysis.

• 出版日期2015-6