predictive value of 18 f-fdg pet/ct in patients with acute type b aortic intramural hematoma

The clinical course and predictors of adverse aortic events (aae) in patients with acute stanford type b intramural hematoma (imh) remain controversial. this study aimed to investigate whether 18f-fdg pet/ct can predict risk in patients with acute type b imh. this study included 34 patients with acute type b imh who underwent pet/ct within 14 days from the onset of symptoms. the maximal standardized uptake values (suvmax) of 18f-fdg uptake was significantly different between patients with or without aae (4.3 ± 0.6 vs 3.7 ± 1.0, p = 0.020), but not the target to blood ratio (tbr, suvmax divided by suv in the superior vena cava) (1.6 ± 0.2 vs 1.5 ± 0.5, p = 0.064). in patients with initial ulcer-like projection (ulp), a blood-filled pouch protruding into the imh, which was seen in 25 patients(74%), both the suvmax and tbr were significantly higher in patients who developed aae, (4.3 ± 0.6 vs 3.3 ± 0.5, p = 0.001; 1.6 ± 0.2 vs 1.4 ± 0.2, p = 0.01); the tbr >1.5, which is determined from receiver-operating-characteristic curve, had a sensitivity of 73% and a specificity of 80% in predicting aae. patients with ulp and high 18f-fdg uptake were more likely to develop aae and require closer surveillance with serial imaging.