Skip Navigation LinksHome > April 2013 - Volume 38 - Issue 4 > 18F-FDG PET/CT in Differentiating Acute Tuberculous From Idi...
Clinical Nuclear Medicine:
doi: 10.1097/RLU.0b013e31827a2537
Original Articles

18F-FDG PET/CT in Differentiating Acute Tuberculous From Idiopathic Pericarditis: Preliminary Study

Dong, Aisheng MD*; Dong, Hui MD; Wang, Yang MSc; Cheng, Chao MD*; Zuo, Changjing MD*; Lu, Jianping MD§

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Abstract

Purpose: The aim of this study was to evaluate retrospectively the diagnostic capability of 18F-FDG PET/CT in differentiating acute tuberculous from idiopathic pericarditis.

Methods: FDG PET/CT findings were reviewed in 15 patients with acute tuberculous (n = 5) or idiopathic pericarditis (n = 10). The maximal thickness and SUVmax of the pericardium and the number, size, and SUVmax of the mediastinal and supraclavicular lymph nodes with increased FDG uptake were measured.

Results: All patients had small-to-large amount of pericardial effusion. The patients with acute tuberculous pericarditis (n = 5) showed diffuse (n = 3) or multifocal (n = 2) FDG uptake in the pericardia. The patients with acute idiopathic pericarditis (n = 10) showed diffuse (n = 6) or regional (n = 4) FDG uptake in the pericardia. The mean (SD) pericardial thickness and SUVmax of acute tuberculous pericarditis were significantly higher than those of acute idiopathic pericarditis (5.1 [1.0] vs 3.4 [0.9], P < 0.05; 13.5 [3.9] vs 3.0 [0.7], P < 0.05, respectively). A total of 69 mediastinal and supraclavicular lymph nodes with increased FDG uptake were observed in all 15 patients (44 in patients with acute tuberculous pericarditis and 25 in patients with acute idiopathic pericarditis). The mean (SD) SUVmax of mediastinal and supraclavicular lymph nodes of acute tuberculous pericarditis (5.3 [1.8]) was significantly higher than that of acute idiopathic pericarditis (2.8 [0.6], P < 0.05). There was no significant difference in the mean size of the mediastinal and supraclavicular lymph nodes between acute tuberculous and idiopathic pericarditis.

Conclusions: The degrees of FDG uptake in the pericardium and the mediastinal and supraclavicular lymph nodes are useful for differentiating acute tuberculous from idiopathic pericarditis. Familiarity with the FDG uptake patterns of acute tuberculous and idiopathic pericarditis may be helpful for successful (especially timely) diagnosis and treatment.

© 2013 by Lippincott Williams & Wilkins

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