Arterial wall thickness measurements by B mode ultrasonography in patients with Takayasu's arteritis.

Raninen, Reino O; Kupari, Markku; Pamilo, M.; Pajari, R.; Poutanen, Veli-Pekka; Hekali, P

doi:10.1136/ard.55.7.461

Cited by 35 publications

(31 citation statements)

References 27 publications

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“…Raninen et al documented a signifi cantly increased wall thickness not only of the common carotid but also of the subclavian arteries and the abdominal aorta in patients with TA as compared to healthy controls. In this study, at least one arterial segment with circumferential wall thickening above the reference values was noticed in all 16 patients with TA [62]. In rare cases, poststenotic fl ow patterns resulting from isolated ostial stenoses of the supraaortic arteries are the only sonographic fi ndings.…”

Section: Disease Pattern As Assessed By Ultrasoundsupporting

confidence: 49%

“…Abnormal fl ow patterns (fl at and dampened waveform, turbulent fl ow) in the abdominal aorta may be indirect signs of stenotic disease of the thoracic aorta. The abdominal aorta is aff ected by vasculitic wall thickening in up to two thirds of patients [62], and in rare cases obstructions of the suprarenal or pararenal aorta (midaortic syndrome) can be found, then resulting in renal and/or mesenteric ischaemia.…”

Section: Disease Pattern As Assessed By Ultrasoundmentioning

confidence: 99%

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Ultrasound imaging in the diagnosis of large vessel vasculitis

Czihal

Lottspeich

Hoffmann

2017

Vasa

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Summary: Nowadays noninvasive vascular imaging has an important role in the diagnostic work-up of the large vessel vasculitides (LVV), most importantly giant cell arteritis (GCA) and Takayasu arteritis. Among the imaging modalities available, ultrasound (US) has several important advantages, including low costs, rapid and repetitive availability without exposure to radiation, and high spatial resolution for assessment of large and medium-sized arteries. Therefore, US can be regarded the fi rst line imaging method in suspected LVV. In patients with suspected GCA, US can replace temporal artery biopsy in certain clinical scenarios, and the application of US early in the diagnostic work-up of suspected GCA in specialized fast track clinics has been suggested to reduce the rate of visual ischaemic complications and associated costs. In other LVV such as Takayasu arteritis and chronic periaortitis, the diagnostic accuracy in comparison to other noninvasive imaging methods has not been formally tested but can be considered to be excellent. However, quality of US is highly dependent on the operator's experience, and assessment of the thoracic aorta which is frequently involved in GCA and TA is limited. The role of US in the followup of LVV under treatment is unclear. In view of the promising data supporting its value on the one hand and several uncertainties and controversies on the other hand, the present review article provides a comprehensive overview on current evidence for the application of US in the diagnosis and follow up of LVV. Recent multicentre study results and emerging trends such as the application of compression sonography in the diagnosis of GCA and the use of contrast enhanced ultrasound in disease activity assessment in Takayasu arteritis are discussed.

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Section: Disease Pattern As Assessed By Ultrasoundsupporting

confidence: 49%

Section: Disease Pattern As Assessed By Ultrasoundmentioning

confidence: 99%

Ultrasound imaging in the diagnosis of large vessel vasculitis

Czihal

Lottspeich

Hoffmann

2017

Vasa

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“…Several studies have emphasized the usefulness of the arterial wall thickness measurement. 8,29,30 Moreover, a regression of carotid wall thickening after corticosteroid therapy has been reported. 31,32 Therefore, in addition to its diagnostic capabilities, carotid ultrasonography may provide a simple and accurate method for the evaluation of therapeutic effects of immunosuppressive drugs in TA.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Cerebrovascular Assessment of Takayasu Arteritis

Cantú

Pineda

Barinagarrementería

et al. 2000

Stroke

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Background and Purpose-Despite prominent neurological symptoms reported in Takayasu arteritis (TA), a complete evaluation of the cerebral circulation has not been consistently performed. The purpose of this study is to describe MR angiography (MRA), color Doppler flow imaging, and transcranial Doppler (TCD) findings in the extracranial and intracranial cerebral arteries in TA. Methods-MRA, color Doppler flow imaging, and TCD were performed in 21 patients with TA. Intima-media thickness was measured in the common carotid artery. The correlation between noninvasive studies and panaorto-arteriography was examined for supraortic vessels. Cerebral angiography findings were compared with the noninvasive methods in 7 patients. Intracranial hemodynamic changes detected by TCD were compared with extracranial circulation lesions assessed by panaorto-arteriography. Results-Noninvasive vascular techniques showed at least 1 abnormality in the extracranial and/or intracranial cerebral arteries in 20 of 21 patients (95%). Both MRA and color Doppler flow imaging showed a substantial correlation in the ability to detect obstructive lesions in supra-aortic vessels compared with panaorto-arteriography. High-resolution ultrasonography displayed common carotid artery wall thickening in 5 vessels that were considered normal by arteriography. In 24% of patients, MRA and TCD showed abnormalities consistent with stenosis of the basal cerebral arteries. In 10 patients with severe extracranial circulation involvement (detected by arteriography), TCD displayed intracranial hemodynamic changes consisting of dampened or blunted waveforms with low pulsatility. Conclusions-The comprehensive assessment of cerebral circulation in TA patients by noninvasive methods allowed the detection of a high rate of diverse vascular abnormalities in both extracranial and intracranial circulation. (Stroke.

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“…79,81 Marked thickening of the intimal-medial complex may be seen in the subclavian and common carotid arteries, in particular, and often is bilateral. 81,[83][84][85] Duplex ultrasound also may identify areas of arterial stenosis or occlusion in the setting of both GCA and Takayasu arteritis. Thickness of the carotid intimal-medial complex has shown early promise as a quantifiable marker of disease activity among patients with Takayasu arteritis and may have potential as a marker of therapeutic response among patients receiving immunosuppressive therapy.…”

Section: Ultrasoundmentioning

confidence: 99%