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Li Z, Zheng Z, Ding J, Li X, Zhao Y, Kang F, Li Y, Pang L, Du W, Wu Z, Zhu P. Contrast-enhanced Ultrasonography for Monitoring Arterial Inflammation in Takayasu Arteritis. J Rheumatol 2019; 46:616-622. [PMID: 30824642 DOI: 10.3899/jrheum.180701] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the utility of contrast-enhanced ultrasound (CEUS) compared with 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in assessing vessel inflammation of Takayasu arteritis (TA). METHODS This is a retrospective analysis of 71 patients with TA who had undergone carotid CEUS. Twenty-two of 71 patients underwent FDG-PET after CEUS. Clinical disease activity was assessed by Kerr criteria and the Indian Takayasu Clinical Activity Score 2010 (ITAS2010). We investigated the correlation between carotid vascularization on CEUS and clinical data. The consistency of carotid CEUS and PET data has been analyzed for TA disease activity. RESULTS There was a statistically significant correlation between the results of CEUS and ITAS2010 (p = 0.004) or Kerr criteria (p < 0.001). According to ITAS2010, thirty-four of 71 patients with TA were clinically inactive. Assessment of 34 TA patients with clinically inactive disease yielded 11 CEUS scans that showed active lesions (visual grade ≥ 2) in the left or right carotid artery. In 22 cases that underwent CEUS and FDG-PET, 12 were active and 10 were inactive on the basis of ITAS2010. Moreover, bilateral carotid CEUS vascularization score positively correlated with vascular FDG uptake in these patients with TA (p = 0.004). When vascular inflammation was defined as FDG uptake with visual grade ≥ 2, carotid CEUS showed sensitivity of 100% and specificity of 80%. CONCLUSION For TA patients with clinically inactive disease, CEUS could help clinicians to identify active lesions in the carotid vascular region. Carotid CEUS may be a rapid and cost-effective imaging tool in the followup of patients with TA.
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Affiliation(s)
- ZhiQin Li
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - ZhaoHui Zheng
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - Jin Ding
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - XiaoFeng Li
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - YongFeng Zhao
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - Fei Kang
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - Ying Li
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - LinXuan Pang
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - WangLei Du
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - ZhenBiao Wu
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work
| | - Ping Zhu
- From the Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China. .,Z.Q. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.H. Zheng, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; J. Ding, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; X.F. Li, MS, Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University; Y.F. Zhao, MS, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University; F. Kang, MD, PhD, Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University; Y. Li, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; L.X. Pang, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; W.L. Du, MS, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; Z.B. Wu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University; P. Zhu, MD, PhD, Department of Clinical Immunology, Institute of Rheumatism and Immunity, PLA, Xijing Hospital, Fourth Military Medical University. ZhiQin Li and ZhaoHui Zheng contributed equally to this work.
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