Original Research

Use of Contrast-Enhanced Ultrasound for Detecting the Disease Activity of the Carotid Artery in Takayasu Arteritis

  • Li, MD Chaolun ,
  • Ma, MD Lingying ,
  • Huang, MD Linjin ,
  • Han, MD Hong ,
  • Jiang, MD Lingdi ,
  • Wang, MD Wenping
Expand
  • a Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
    b Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
    c Department of Ultrasound, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China

Received date: 2020-02-23

  Online published: 2020-08-21

Abstract

Objective: To investigate whether contrast-enhanced ultrasound (CEUS) is helpful for assessing the disease activity of Takayasu arteritis (TA).
Methods: Eighty-four patients with TA were examined with ultrasound (US) and CEUS. Intima-media thickness (IMT) of both sides of the common carotid artery was measured for each patient. Semiquantitative analyses of contrast enhancement within the arterial wall were performed with a visual interpretation scale. Disease activity was determined by one experienced physician based on Physician Global Assessment criteria.
Results: Carotid CEUS revealed that 6 arteries showed no enhancement (7.1%, 6/84) while 78 arteries showed homogeneous enhancement within the thickened wall (92.9%, 78/84). Grade 1 enhancement was noted in 40 patients, and grade 2 in 38 patients. IMT of the active group was significantly thicker than that of the inactive group (2.4 ± 0.9 mm vs. 1.8 ± 0.5 mm, P = 0.001) on B-mode US, and slightly correlated with ESR (r = 0.344, P < 0.05) and CRP (r = 0.261, P < 0.05). Grade 2 enhancement was observed more in the active patients (61.7% vs. 41.3%, P = 0.001) on CEUS.
Conclusions: CEUS is a convenient and non-invasive imaging modality that is useful for evaluating disease activity in TA patients by assessing the vascularization within the carotid wall.

Cite this article

Li, MD Chaolun , Ma, MD Lingying , Huang, MD Linjin , Han, MD Hong , Jiang, MD Lingdi , Wang, MD Wenping . Use of Contrast-Enhanced Ultrasound for Detecting the Disease Activity of the Carotid Artery in Takayasu Arteritis[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2020 , 4(3) : 189 -194 . DOI: 10.37015/AUDT.2020.200010

References

[1] Vaideeswar P, Deshpande JR. Pathology of Takayasu arteritis: A brief review. Ann Pediatr Cardiol 2013; 6:52-8.
[2] Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002; 55:481-6.
[3] Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford) 2014; 53:793-801.
[4] Direskeneli H, Aydin SZ, Merkel PA. Assessment of disease activity and progression in Takayasu's arteritis. Clin Exp Rheumatol 2011; 29:S86-S91.
[5] Feinstein SB. Contrast ultrasound imaging of the carotid artery vasa vasorum and atherosclerotic plaque neovascularization. J Am Coll Cardiol 2006; 48:236-43.
[6] Coli S, Magnoni M, Sangiorgi G, Marrocco-Trischitta MM, Melisurgo G, Mauriello A, et al. Contrast-enhanced ultrasound imaging of intraplaque neovascularization in carotid arteries: correlation with histology and plaque echogenicity. J Am Coll Cardiol 2008; 52:223-30.
[7] Magnoni M, Dagna L, Coli S, Cianflone D, Sabbadini MG, Maseri A. Assessment of Takayasu arteritis activity by carotid contrast-enhanced ultrasound. Circ Cardiovasc Imaging 2011; 4:e1-e2.
[8] Giordana P, Baque-Juston MC, Jeandel PY, Mondot L, Hirlemann J, Padovani B, et al. Contrast-enhanced ultrasound of carotid artery wall in Takayasu disease: first evidence of application in diagnosis and monitoring of response to treatment. Circulation 2011; 124:245-7.
[9] Schinkel AF, van den Oord SC, van der Steen AF, van Laar JA, Sijbrands EJ. Utility of contrast-enhanced ultrasound for the assessment of the carotid artery wall in patients with Takayasu or giant cell arteritis.Eur Heart J Cardiovasc Imaging 2014; 15:541-6.
[10] Herlin B, Baud JM, Chadenat ML, Pico F. Contrast-enhanced ultrasonography in Takayasu arteritis: watching and monitoring the arterial inflammation.BMJ case reports. DOI: 10.1136/bcr-2015-211094.
[11] Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990; 33:1129-34.
[12] Staub D, Partovi S, Schinkel AF, Coll B, Uthoff H, Aschwanden M, et al. Correlation of carotid artery atherosclerotic lesion echogenicity and severity at standard US with intraplaque neovascularization detected at contrast-enhanced US. Radiology 2011; 258:618-26.
[13] Germano G, Macchioni P, Possemato N, Boiardi L, Nicolini A, Casali M, et al. Contrast-Enhanced Ultrasound of the Carotid Artery in Patients with Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings. Arthritis Care Res (Hoboken) 2017; 69:143-9.
[14] Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med 1994; 120:919-29.
[15] Park SH, Chung JW, Lee JW, Han MH, Park JH. Carotid artery involvement in Takayasu's arteritis: evaluation of the activity by ultrasonography. J Ultrasound Med 2001; 20:371-8.
[16] Romera-Villegas A, Vila-Coll R, Poca-Dias V, Cairols-Castellote MA. The role of color duplex sonography in the diagnosis of giant cell arteritis. J Ultrasound Med 2004; 23:1493-8.
[17] Seth S, Goyal NK, Jagia P, Gulati G, Karthikeyan G, Sharma S, et al. Carotid intima-medial thickness as a marker of disease activity in Takayasu's arteritis. Int J Cardiol 2006; 108:385-90.
[18] Wang Y, Li JC, Liu H, Wang L, Qi ZH, Kong J. Ultrasound features in the diagnosis of Takayasu’s arteritis with carotid artery involvement and evaluation of disease activity. Med J PUMCH 2014; 5:81-7.
[19] Kono Y, Pinnell SP, Sirlin CB, Sparks SR, Georgy B, Wong W, et al. Carotid arteries: contrast-enhanced US angiography--preliminary clinical experience. Radiology 2004; 230:561-8.
[20] Hoogi A, Adam D, Hoffman A, Kerner H, Reisner S, Gaitini D. Carotid plaque vulnerability: quantification of neovascularization on contrast-enhanced ultrasound with histopathologic correlation. Am J Roentgenol 2011; 196:431-6.
[21] Li C, He W, Guo D, Chen L, Jin X, Wang W, et al. Quantification of carotid plaque neovascularization using contrast-enhanced ultrasound with histopathologic validation. Ultrasound Med Biol 2014; 40:1827-33.
[22] Schmidt J, Kermani TA, Bacani AK, Crowson CS, Cooper LT, Matteson EL, et al. Diagnostic features, treatment, and outcomes of Takayasu arteritis in a US cohort of 126 patients. Mayo Clin Proc 2013; 88:822-30.
[23] Mavrogeni S, Dimitroulas T, Chatziioannou SN, Kitas G. The role of multimodality imaging in the evaluation of Takayasu arteritis. Semin Arthritis Rheum 2013; 42:401-12.
Outlines

/