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Abstract Number: 219

Contrast-Enhanced Ultrasound Of The Sovraortic Arteries: The Potential Role In Monitoring Disease Activity and Response To Treatment In Large Vessel Vasculitis

Giuseppe Germanò1, Pierluigi Macchioni1, Niccolò Possemato2 and Carlo Salvarani3, 1Rheumatology Service, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, 2S.C. Reumatologia, Arcispedale Santa Maria Nuova, I.R.C.C.S., Reggio Emilia, Italy, 3Rheumatology, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Disease Activity, large vessel vasculitis, positron emission tomography (PET), takayasu arteritis and ultrasonography

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Session Information

Title: Imaging of Rheumatic Diseases I: Imaging in Gout, Pediatric, Soft and Connective Tissue Diseases

Session Type: Abstract Submissions (ACR)

Background/Purpose: promising data has been recently published about the role of contrast-enhanced ultrasound (CEU) in the diagnosis and follow up of Takayasu arteritis (TA) -1,2-

Objective: to assess the role of CEU examination of the carotid artery in patients with large vessel vasculitis (LVV) compared to Positron Emission Tomography (PET).

Methods: 10 patients (8 TA,2 LVV, mean age 46±19y, mean disease duration 3.9±3.1y) were contemporary evaluated with total body PET and carotid arteries US gray scale and CEU (Esaote MyLab70, 13-5MH linear probe, contrast agent Sonovue). All the patients underwent complete clinical examination and laboratory determination of  acute phase reactants. Imaging results were reported using a semiquantitave score ranging from 0 (no activity) to 3 (high activity). Comparison between the two tests were made using Cohen K test. 

Results: At US gray scale examination 8/10 patients have high intima/media thickness (mean 1,5 mm ±0.46). In patients with positive contrast enhanced ultrasound the mean carotid intima-media thickness was 2,1mm ±0.48, while patients with negative contrast enhanced ultrasound presented a mean wall thickness of 0,9mm ±0.47; P = 0.009. There was no significant differences in clinical, demographic and laboratory data between patients with active and inactive disease. All the 4 patients with high/medium carotid activity at PET examination presented positive (activity score >1) CEU. Five of the 6 patients with low/absent PET signal have negative (activity score <2) CEU (K test = 0.800, good concordance).

Conclusion: CEU have a good concordance with PET. These results outline the potential role of CEU to be used in monitoring disease activity and response to treatment in LVV

Refercences:

1. Magnoni M. et al.; Assessment of Takayasu arteritis activity by carotid contrast-enhanced ultrasound. Circ Cardiovasc Imaging. 2011 Mar;4(2):e1-2

2. Giordana P 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


Disclosure:

G. Germanò,
None;

P. Macchioni,
None;

N. Possemato,
None;

C. Salvarani,
None.

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