Is PET MRI valuable in inflammation or fever of unknown aetiology?
|Fakulta / Pracoviště MU|
|Popis||Purpose: To evaluate the benefit of PET/MR imaging in diagnostic process of patients with inflammatory disease of unknown aetiology. Methods and Materials: 51 patients were selected for PET/MR imaging due to inflammation of unknown aetiology, these represent 2.5 % of all PET/MR examinations (total of 2056 examinations; Signa; GE) acquired in tertiary referral hospital since 7/2016. All patients underwent intensive investigation lasting at least 20 days (screening x-rays; abdominal ultrasound, dedicated CT or MRI focused in clinical suspect). Clinical (fever; artralgia; weight loss; night sweating) and laboratory (CRP, leukocytes) were monitored and correlated with PET/MR findings. Based on suspected aetiology patients were divided into 3 groups - fewer of unknown origin (26), unknown infection (13) and rheumatic disease (12). Patients were followed up until the aetiology was diagnosed or symptoms faded away. Results: In 26 (51%) patients diagnosis was proved, in 22 (43%) patients symptoms disappeared, in 3 patients symptoms persisted without explanation. PET/MR strongly supported or changed the diagnosis in 42% of cases (70% in subgroup of rheumatoid infections). As most important marker of conclusive PET/MR was shown artralgia and elevated level of CRP at the time of examination, which were present in 54% of diagnosed cases. PET/MR proved diagnosis of rheumatoid disease in 18 patients (50% without any clinical suspicion), overall sensitivity was up to 89% and specificity 100%, negative predictive value was 85%. Conclusion: PET-MRI is a useful tool in the evaluation of inflammatory disease of unknown aetiology especially in patients with suspected rheumatoid disease.|