A Long-term Persistent Vascular Fluorodeoxyglucose Uptake in a Patient with Large-vessel Vasculitis

Abstract

We herein report a case of large-vessel vasculitis in a 57-year-old woman who developed an intermittent fever and weight loss. While contrast-enhanced computed tomography was noncontributory, positron emission tomography-computed tomography (PET-CT) revealed the diffuse, intense uptake of fluorodeoxyglucose (FDG) in the aorta and its branches. Although she had no signs of relapse after successful oral corticosteroid therapy, PET-CT at 30 months revealed a persistent FDG uptake in the large vessels, which warranted regular follow-up imaging for vascular complications. In cases with an intense FDG uptake at the diagnosis, PET-CT follow-up after clinical remission may help predict the risk of relapse and vascular complications.

Keywords: Takayasu arteritis; diagnosis; follow-up; giant cell arteritis; large vessel vasculitis; positron emission tomography-computed tomography.

Figure 1.

(A) Contrast-enhanced computed tomography showing slight thickening of the aortic wall, which was non-contributory (arrowheads). (B) Positron emission tomography-computed tomography showing an intense fluorodeoxyglucose uptake in the corresponding aortic lesion.

Figure 2.

(A) Baseline positron emission tomography-computed tomography: a diffuse, intense fluorodeoxyglucose uptake is observed in the thoracic and abdominal aorta and common carotid, subclavian, iliac, and femoral arteries. (B) The 30-month follow-up findings of positron emission tomography-computed tomography showing a mild fluorodeoxyglucose uptake in the aorta, common carotid arteries, and subclavian arteries (arrowheads).