Takayasu Arteritinde Karotis İntima Media Elastikiyetinin SWE ile Değerlendirilmesi

Abstract

Bu çalışmanın amacı Takayasu Arteriti (TA) hastalarında Ultrasonografi (US) ile karotis morfolojisini ve Shear Wave Elastografi (SWE) ile arteriyel sertliği değerlendirmek ve sonuçları hastalık aktivitesi ile karşılaştırmaktır. Klinik arşiv taranmış ve karotis tutulumu olan, karotis US ve SWE görüntülemesi yapılmış 41 TA hastası bulundu. Karotis duvarını etkileyebilecek kafa karıştırıcı faktörleri olan hastalar (n:22) çalışma dışı bırakıldı. Dahil edilme kriterlerini karşılayan 19 hasta ve yaş ve cinsiyet açısından benzer 19 sağlıklı kontrol olgusu karşılaştırıldı. B-Mode US ile sağ ve sol ana karotis arter intima-media kalınlığı (IMT) ve SWE ile duvar sertliği değerlendirildi. Ayrıca hastalık aktivasyonu ile arteriyel sertlik arasındaki ilişki de araştırıldı. Karotis arter İMK, TA'da kontrol grubuna kıyasla anlamlı derecede yüksek bulundu (p<0,001). Karotis duvarı için medyan sertlik değerleri TA'da sağ ve solda sırasıyla 28,3 kPa ve 36,3 kPa, kontrol grubunda ise 26,1 kPa ve 28,1 kPa idi. Sol CCA sertliği TA'da kontrol grubuna kıyasla anlamlı derecede yüksekken (p=0,03), sağ CCA sertliğinde anlamlı farklılık saptanmadı. TA'da 52 kPa'lık sol CCA cut-off değeri %100 özgüllük ve %36,8 duyarlılık ile en yüksek doğruluğa ulaşmıştır. Hastalık aktivasyonu ile elastikiyet değeri arasında anlamlı bir ilişki bulunmadı. SWE tek başına tanısal değildir, ancak karotis tutulumunu değerlendirmede B-Mode US'ye ek olarak yararlı bir yöntem olabilir.

Keywords

• Takayasu Arteriti
• Ultrason
• Shear Wave Elastography
• Karotis Sertliği
• İntima Media Kalınlığı

Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography

Abstract

This study aimed to evaluate carotid morphology with Ultrasound (US) and arterial stiffness with Shear Wave Elastography (SWE) in TA patients and to compare results with disease activity. We searched the clinical archive and found 41 Takayasu Arteritis (TA) patients with carotid involvement had carotid US and SWE screening. Patients (n=22) with confounding factors that could affect the carotid wall were excluded. Nineteen cases that meet the inclusion criteria and 19 healthy control cases age-sex matched were compared. We evaluated right and left common carotid artery intima-media thickness (IMT) with B-Mode US and wall stiffness with SWE. We also investigated a relationship between disease activation and arterial stiffness. Carotid artery IMT was significantly higher in TA than in the control group (p<0.001). Median stiffness values for the carotid wall in TA were 28.3 kPa and 36.3 kPa on the right and left and in the control group 26.1 kPa and 28.1 kPa, respectively. The left CCA stiffness was significantly higher in the TA than in the control group (p=0.03), whereas the difference in right CCA elasticity did not reach statistical significance. A left CCA cut-off value of 52 kPa reached the highest accuracy with a specificity of 100% and a sensitivity of 36.8% in TA. No significant relationship was found between disease activation and elasticity value. SWE alone is not diagnostic but can be a useful adjunctive modality to gray-scale ultrasound in assessing carotid artery involvement with TA.

Keywords

• Takayasu Arteritis
• Ultrasound
• Shear Wave Elastography
• Carotid Stiffness
• Intima Media Thickness

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