大血管炎治疗前后对比增强计算机断层扫描结果的比较及其意义:高安动脉炎与巨细胞动脉炎的差异。

IF 1.3 Q4 RHEUMATOLOGY European journal of rheumatology Pub Date : 2024-10-14 DOI:10.5152/eurjrheum.2024.24056
Daiki Nakagomi, Tatsuya Shimizu, Shunsuke Furuta, Takahiro Sugiyama, Kei Kobayashi, Yoshiaki Kobayashi, Shunichiro Hanai, Kimie Harama, Takeyuki Kanzaki, Chisaki Ajima, Takao Sugiyama, Hiroshi Onishi, Hiroshi Nakajima
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引用次数: 0

摘要

目的:影像学检查对诊断大血管炎(LVV)至关重要。在影像诊断过程中,分别评估疾病活动和血管损伤非常重要。急性期的检查结果代表疾病的活动性,而慢性期的检查结果则代表血管损伤;然而,影像学检查结果是急性还是慢性可能并不清楚。我们研究了血管病变在治疗前后的变化情况,以及这些病变是急性期还是慢性期:方法:我们招募了 51 名左心室积液患者,他们在治疗前和治疗后 1-4 个月接受了从颈部到骨盆的造影剂增强计算机断层扫描(CT)。对从颈总动脉到髂总动脉的 21 条血管的管壁增厚、管壁对比度增强、狭窄、闭塞、扩张、动脉瘤和钙化进行了半定量评估:24名患者被诊断为高安动脉炎(TAK),27名患者被诊断为巨细胞动脉炎(GCA)。治疗后血管壁增厚和血管壁对比度增强均有所改善,这在 GCA 组中尤为明显。治疗前后,血管狭窄、闭塞、扩张、动脉瘤或钙化情况无明显差异。TAK组血管狭窄和闭塞更常见,而GCA组血管钙化更常见:结论:血管壁增厚和血管壁对比增强是急性期的结果(活动),而血管狭窄、闭塞、扩张、动脉瘤和钙化则是慢性期的结果(损伤)。TAK和GCA出现这些结果的频率不同。
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Comparison and Significance of Contrast-Enhanced Computed Tomographic Findings of Large-Vessel Vasculitis Before and After Treatment: Differences Between Takayasu Arteritis and Giant Cell Arteritis.

Objective: Imaging is essential for diagnosing large-vessel vasculitis (LVV). During diagnostic imaging, assessing disease activity and vascular damage separately is important. Acute-phase findings represent disease activity, while chronic-phase findings represent vascular damage; however, whether the imaging findings are acute or chronic may be unclear. We investigated how vascular lesions change before and after treatment and whether they were acute- or chronic-phase findings.

Methods: Fifty-one patients with LVV who had undergone contrast-enhanced computed tomography (CT) scans from the neck to the pelvis before treatment and 1-4 months after treatment were recruited. Wall thickening, wall contrast enhancement, stenosis, occlusion, dilation, aneurysm, and calcification were semi-quantitatively assessed in 21 vessels from the common carotid to the common iliac artery.

Results: Twenty-four patients were diagnosed with Takayasu arteritis (TAK), and 27 with giant cell arteritis (GCA). Wall thickening and wall contrast enhancement improved after the treatment, which was especially significant in the GCA group. No significant differences in stenosis, occlusion, dilation, aneurysm, or calcification were observed before and after treatment. Stenosis and occlusion were more common with TAK, while calcification was more common with GCA.

Conclusion: Wall thickening and wall contrast enhancement are acute-phase findings (activity), while stenosis, occlusion, dilation, aneurysm, and calcification are chronic-phase findings (damage). The frequencies of these findings differ between TAK and GCA.

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