PDF(Pubmed)
Abstract：
Infectious aortitis (IA) is a rare and life-threatening cardiovascular disease. Early diagnosis and timely intervention are crucial for reducing mortality associated with mycotic aortic aneurysms (MAAs); however, early diagnosis is challenging due to the nonspecific symptoms. Some cases are diagnosed at an advanced stage or after developing complications, such as rupture or aortic fistula. Current state-of-the-art imaging modalities-including computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT-can detect infected aneurysms in clinically suspicious cases. MAA features on imaging include lobulated pseudoaneurysm, indistinct irregular arterial wall, perianeurysmal gas, perianeurysmal edema, perianeurysmal soft tissue mass, aneurysmal thrombosis, and high metabolic activity with increased uptake of FDG. Enlarged lymph nodes are often found adjacent to the aneurysm, while iliopsoas abscess (IPA), spondylitis, and aortic fistulas are commonly associated complications. After surgery or endovascular repair, radiological features-including ectopic gas, peri-graft fluid, thickening of adjacent bowel, pseudoaneurysm formed at the graft anastomosis, and increased uptake of FDG-may indicate an infection of aortic graft. This article provides an overview of the clinical and imaging features of MAAs. Thus, familiarity with the imaging appearances of MAAs may assist radiologists in the diagnosis and facilitation of timely treatment.
摘要：
感染性主动脉炎（IA）是一种罕见且危及生命的心血管疾病。早期诊断和及时干预对于降低与霉菌性主动脉瘤（MAAs）相关的死亡率至关重要；然而，由于非特异性症状,早期诊断具有挑战性.一些病例在晚期或出现并发症后被诊断出，如破裂或主动脉瘘。当前最先进的成像模式-包括计算机断层扫描（CT），磁共振成像（MRI），和18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/CT-可以在临床可疑病例中检测感染的动脉瘤。成像上的MAA特征包括分叶状假性动脉瘤，不明显的不规则动脉壁，动脉瘤周围气体，动脉瘤周围水肿，动脉瘤周围软组织肿块，动脉瘤血栓形成，和高代谢活性与FDG的摄取增加。通常在动脉瘤附近发现肿大的淋巴结，而髂腰肌脓肿（IPA），脊柱炎,主动脉瘘是常见的并发症。手术或血管内修复后，放射学特征-包括异位气体，移植物周围的液体，邻近的肠增厚，在移植物吻合处形成假性动脉瘤，FDG的摄取增加可能表明主动脉移植物感染。本文就MAAs的临床和影像学特点作一综述。因此，熟悉MAAs的影像学表现可能有助于放射科医生的诊断和及时治疗。
