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Positron emission tomography (PET) evaluation of abdominal aortic aneurysm (AAA)
N Sakalihasan1, H Van Damme, P Gomez
1Department of Cardiovascular Surgery, University Hospital of Liège, CHU Sart-Tilman, 4000 Liege, Belgium. nsaka@chu.ulg.ac.be
Background:
aneurysmal disease is associated with an inflammatory cell infiltrate and enzymatic degradation of the vessel wall.
Aim Of The Study:
to detect increased metabolic activity in abdominal aortic aneurysms (AAA) by means of positron emission tomography (PET-imaging).
Study Design:
twenty-six patients with AAA underwent PET-imaging.
Results:
in ten patients, PET-imaging revealed increased fluoro-deoxy-glucose (18-FDG) uptake at the level of the aneurysm. Patients with positive PET-imaging had one or more of the following elements in their clinical history: history of recent non-aortic surgery (n = 4), a painful inflammatory aortic aneurysm (n = 2), moderate low back pain (n = 2), rapid (> 2;5 mm in 6 months) expansion (n = 4), discovery by PET-scan of a previously undiagnosed lung cancer (n = 3) or parotid tumour (n = 1). Five patients with a positive PET scan required urgent surgery within two to 30 days. Among the 16 patients with negative PET-imaging of their aneurysm, only one had recent non-aortic surgery, none of them required urgent surgery, only two had a rapidly expanding AAA, and in only one patient, PET-imaging revealed an unknown lung cancer.
Conclusion:
these data suggest a possible association between increased 18-FDG uptake and AAA expansion and rupture.