First Experience of Imaging Large Vessel Vasculitis With Fully Integrated Positron Emission Tomography/MRI by Ingo Einspieler, Klaus Thürmel, Matthias.

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Presentation transcript:

First Experience of Imaging Large Vessel Vasculitis With Fully Integrated Positron Emission Tomography/MRI by Ingo Einspieler, Klaus Thürmel, Matthias Eiber, and Markus Essler Circ Cardiovasc Imaging Volume 6(6):1117-1119 November 19, 2013 Copyright © American Heart Association, Inc. All rights reserved.

Coronal slices of positron emission tomography (PET; A), T2w short τ inversion recovery (STIR; B), and fused PET/MRI images (C) show an intense radiotracer uptake in the infrarenal aortic wall (red arrow) as well as wall thickening and edema (white arrow) over ≈7 cm. Coronal slices of positron emission tomography (PET; A), T2w short τ inversion recovery (STIR; B), and fused PET/MRI images (C) show an intense radiotracer uptake in the infrarenal aortic wall (red arrow) as well as wall thickening and edema (white arrow) over ≈7 cm. The fused data set showed a perfect coregistration and excellent concordance of PET and T2w STIR images (C), which was visually ascertained by 2 experienced readers (1 nuclear medicine physician and 1 radiologist). Ingo Einspieler et al. Circ Cardiovasc Imaging. 2013;6:1117-1119 Copyright © American Heart Association, Inc. All rights reserved.

Axial T1-weighted fat-suppressed dark blood images (top) show thickening of the aortic wall (red arrow) with infiltration of the surrounding mesenterium before (A) and after (C) application of contrast media, as well as significant contrast enhancement of the infrarenal aortic wall indicating active inflammation (C). Axial T1-weighted fat-suppressed dark blood images (top) show thickening of the aortic wall (red arrow) with infiltration of the surrounding mesenterium before (A) and after (C) application of contrast media, as well as significant contrast enhancement of the infrarenal aortic wall indicating active inflammation (C). The corresponding axial positron emission tomogram (bottom) with pathological [18F]-fluoro-desoxyglucose accumulation in the center (B), which exactly projects onto the thickened wall seen on MRI (D). Ingo Einspieler et al. Circ Cardiovasc Imaging. 2013;6:1117-1119 Copyright © American Heart Association, Inc. All rights reserved.

Three-dimensional fusion of maximum intensity projection–contrast-enhanced magnetic resonance angiography and positron emission tomography (PET) demonstrates normal contrast enhancement in the vessels but intense and extensive accumulation of [18F]-fluoro-desoxyglucose surrounding the infrarenal aorta including the aortic bifurcation (white arrow), corresponding to the inflamed aortic wall seen. Three-dimensional fusion of maximum intensity projection–contrast-enhanced magnetic resonance angiography and positron emission tomography (PET) demonstrates normal contrast enhancement in the vessels but intense and extensive accumulation of [18F]-fluoro-desoxyglucose surrounding the infrarenal aorta including the aortic bifurcation (white arrow), corresponding to the inflamed aortic wall seen. PET shows that no other vessel segment is involved. High uptake in projection on the renal pelvis and bladder is related to physiological excretion. Ingo Einspieler et al. Circ Cardiovasc Imaging. 2013;6:1117-1119 Copyright © American Heart Association, Inc. All rights reserved.

Multiplanar reconstruction–contrast-enhanced magnetic resonance angiography in sagittal (A), axial (B), and coronal (C) view shows aneurysmatic dilatation of the ascending aorta (red arrows) with ≈5 cm in diameter. Multiplanar reconstruction–contrast-enhanced magnetic resonance angiography in sagittal (A), axial (B), and coronal (C) view shows aneurysmatic dilatation of the ascending aorta (red arrows) with ≈5 cm in diameter. Ingo Einspieler et al. Circ Cardiovasc Imaging. 2013;6:1117-1119 Copyright © American Heart Association, Inc. All rights reserved.