Seoul St. Mary’s Hospital Professor Jeong Mi-hyang’s team confirms the usefulness of echocardiography + positron emission tomography treatment evaluation
▲Echocardiogram: (Before treatment) A, B / (After treatment) A’, B’. ▲Positron emission tomography: (Before treatment) C / (After treatment) D. The pericardium, which was bright before treatment, is showing similar shade to the nearby area after treatment.
Tuberculosis has the highest number of deaths among domestic infectious diseases, excluding COVID-19. Although Korea’s tuberculosis patient indicators have improved significantly, it still ranks first in incidence and third in mortality among OECD member countries. In particular, about 1-2% of all tuberculosis patients suffer from tuberculosis pericarditis, so research on this is also necessary.
Among these, domestic medical staff presented a new approach to the diagnosis and treatment of tuberculous pericarditis and proved its effectiveness.
The Catholic University of Korea’s Seoul St. Mary’s Hospital recently conducted a research team led by professors Mihyang Jeong (corresponding author) of the Department of Cardiovascular Medicine and Juhyeon Oh (co-first author) of the Department of Nuclear Medicine at the Cardiocerebrovascular Hospital. Effective treatment by utilizing multidisciplinary imaging tests such as echocardiography and positron emission tomography (18F-FDG PET/CT) not only for the initial diagnosis of tuberculous pericarditis but also for checking the treatment progress.He said he did.
Pericarditis is a disease that is commonly expressed as fluid in the heart. In tuberculous pericarditis, the pericardium, which protects the heart, becomes infected with tuberculosis bacteria and fills with exudate, putting pressure on the heart and causing heart failure. Symptoms such as chest pain, cough, and shortness of breath are often accompanied by non-specific systemic symptoms such as fever, cold sweat, fatigue, and weight loss.
Above all, a complex strategy that combines various imaging tests and specimen tests, including echocardiography, CT, MRI, and positron emission tomography, has been proposed to differentially diagnose tuberculous pericarditis. A method to evaluate progress after treatment has not yet been specifically established..
Among these, the research team used positron emission tomography as an adjunct to echocardiography on a patient with tuberculous pericarditis in his 70s who visited the hospital complaining of difficulty breathing and quantitatively confirmed the degree of improvement in inflammation within the heart.
Positron emission tomography is a test that takes advantage of the fact that glucose usage is significantly higher in tumor cells or inflamed areas compared to normal cells, and checks the shape of the area that glows relatively brightly after injecting a glucose analogue containing an isotope into the body. Previously, it was mainly used for diagnosis and follow-up of cancer patients. Recently, it has also been used as a test to check the presence and extent of inflammation.It is becoming.
The research team said, “Treatment for tuberculosis pericarditis is generally terminated after taking anti-tuberculosis drugs for 6 months, and at this time, it was difficult to accurately determine whether the inflammation was improved through echocardiography alone.”If positron emission tomography can be used as an auxiliary method to determine the level of inflammation at the end of treatment, the risk of adhesive pericarditis due to recurrence or complications of tuberculous pericarditis can be minimized and an individualized treatment strategy can be established.“You can do it,” he explained.
Professor Jeong Mi-hyang said, “This study shows that positron emission tomography goes beyond the initial diagnosis of pericardial disease. Confirmed that there is sufficient value in post-treatment progress evaluation“We will strive to provide safer treatment to tuberculous pericarditis patients, who have a high proportion of elderly patients,” he said.
Meanwhile, the results of this study were published on March 27 in ‘European Heart Journal – Cardiovascular Imaging’ (citation index 6.2).
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2024-04-09 11:41:10
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