Session Title: Vasculitis
Session Type: Abstract Submissions (ACR)
Large vessel involvement has been reported to be present in 20-50% of patients with giant cell arteritis (GCA). Computed tomography (CT) and magnetic resonance (MR) angiography are used for assessment of large vessel involvement in patients with GCA. Our aim was to compare color Doppler ultrasonography (CDUS) to CT/ MR angiography for identifying large vessel involvement in patients with GCA at the time of initial evaluation.
Consecutive GCA patients with large vessel involvement assessed by CDUS underwent CT/MR angiography between January 2010 and May 2012. The aorta and supraaortic vessels were assessed by CT/MR angiography, while the carotid and axillary arteries were assessed by CDUS. The patients were diagnosed by CDUS with large vessel vasculitis (LVV) when intima-media complex thickness was homogenous and more than 1.5 mm in the carotid artery and more than 1 mm in the axillary artery.
A total of 13 GCA patients (7 females, 6 males, mean age 70 years) were identified with LVV using CDUS. In these 13 patients aortic involvement was observed in 5 patients (38%) by CT/MR angiography. In all of these 5 patients, involvement of axillary arteries (4 patients) or carotid arteries (3 patients) were found by CDUS. In the other 8 patients axillary arteritis was visible on CDUS whereas only 2 these patients revealed large vessel vasculitis on CT/MR. Interestingly, inflammation in large vessels was retrospectively identified by CT/MR angiography in 6 of 13 patients and this after reevaluating the images after the positive CDUS examination.
CDUS seems to be a valuable tool for assessment of large vessel vasculitis. The data from our pilot study suggest that CDUS is comparable and even better than CT/MR angiography to detect large vessel involvement in GCA. In the future CDUS may become the gold standard for first line evaluation of large vessel involvement. However further validation of the method is warranted.
A. P. Diamantopoulos,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/color-doppler-ultrasonography-an-alternative-to-ctmr-angiography-for-identifying-large-vessel-involvement-in-giant-cell-arteritis/