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

Yıl 2024, Cilt: 50 Sayı: 3, 457 - 462, 12.01.2025
https://doi.org/10.32708/uutfd.1534895

Öz

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.

Kaynakça

  • 1.Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002;55: 481-486.https://pubmed.ncbi.nlm.nih.gov/12101189/
  • 2.Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, MispiretaJ, Horwitz S, Vela JE. Takayasu's arteritis. Clinical study of107 cases. Am Heart J. 1977 Jan;93(1):94-103. https://pubmed.ncbi.nlm.nih.gov/12655/
  • 3.Andrews J, Mason JC. Takayasu’s arteritis—recent advances inimaging offer promise. Rheumatology (Oxford) 2007; 46:6.https://pubmed.ncbi.nlm.nih.gov/17043053/
  • 4.Dal Canto AJ, Virgin HW. Animal models of infectionmediated vasculitis. 4th ed. Curr Opin Rhematol 1999; 11:17-23. https://pubmed.ncbi.nlm.nih.gov/9894626/
  • 5.Direskeneli H, Aydin SZ, Merkel PA. Disease assessment inTakayasu's arteritis. Rheumatology (Oxford) 2013; 52:1735–1736. https://pubmed.ncbi.nlm.nih.gov/23955648/
  • 6.Lande A, Berkmen YM. Aortitis: pathologic, clinical, andarteriographic review. Radiol Clin North Am 1976; 14:219-240. https://pubmed.ncbi.nlm.nih.gov/9666/
  • 7.Alibaz-Oner F, Direskeneli H. Update on Takayasu’s arteritis.Presse Med 2015;44(Pt2): e259–e265. https://pubmed.ncbi.nlm.nih.gov/26033561/
  • 8.Andrews J, Al-Nahhas A, Pennell DJ, et al. Non-invasive imaging in the diagnosis and management of Takayasu’sarteritis. Ann Rheum Dis 2004; 63:995-1000. https://pubmed.ncbi.nlm.nih.gov/15249328/
  • 9.de Leeuw K, Bijl M, Jager PL. Additional value of positronemission tomography in diagnosis and follow-up of patientswith large vessel vasculitides. Clin Exp Rheumatol2004;22(Suppl 36): S21-S26. https://pubmed.ncbi.nlm.nih.gov/15675130/
  • 10.Bacon P, Direskeneli H. Quantifying disease involvement inTakayasu's arteritis. Rheumatology (Oxford) 2014; 53:1535–1536. https://pubmed.ncbi.nlm.nih.gov/24459218/
  • 11.Nicoletti G, Mannarella C, Nigro A, Sacco A, Olivieri I. The"Macaroni Sign" of Takayasu's arteritis. J Rheumatol. 2009 Sep;36(9):2042-3. https://pubmed.ncbi.nlm.nih.gov/19738209/
  • 12.Cosgrove D, Piscaglia F, Bamber J, et al. EFSUMB guidelinesand recommendations on the clinical use of ultrasoundelastography. Part 2: Clinical applications. Ultraschall in derMedizin 2013; 34:238-253. https://pubmed.ncbi.nlm.nih.gov/23605169/
  • 13.Ferraioli G, Tinelli C, Dal Bello B, et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronichepatitis C: a pilot study. Hepatology 2012; 56:2125-2133. https://pubmed.ncbi.nlm.nih.gov/22767302/
  • 14.Bond JR, Charboneau JW, Stanson AW. Takayasu’s arteritis:carotid duplex sonographic appearance, including colorDoppler imaging. J Ultrasound Med 1990; 9:625–629. https://pubmed.ncbi.nlm.nih.gov/1979636/
  • 15.Sun Y, Yip PK, Jeng JS, Hwang BS, Lin WH.Ultrasonographic study and long-term follow- up of Takayasu's arteritis. Stroke. 1996 Dec;27(12):2178-82. https://pubmed.ncbi.nlm.nih.gov/8969776/
  • 16.Maeda H, Nanda N, Matsumoto M, et al. Carotid lesionsdetected by B-mode ultrasonography in Takayasu’s arteritis: “macaroni sign” as an indicator of the disease. Ultrasound MedBiol 1991; 17:695–701. https://pubmed.ncbi.nlm.nih.gov/1685816/
  • 17.Thomas L, Low J, Chan K, Durbridge G. Shear waveelastography of the cervical arteries: A novel approach to theassessment of cervical arterial wall stiffness. An investigationof psychometric properties and intra-rater reliability.Musculoskelet Sci Pract. 2019 Apr; 40:96-100. https://pubmed.ncbi.nlm.nih.gov/30262424/
  • 18.Thomas LC, Chan K, Durbridge G. Changes in internal carotid and vertebral arterial wall stiffness with head movement can bedetected with shear wave elastography. J Man Manip Ther2020;28(2):103-110. https://pubmed.ncbi.nlm.nih.gov/31663837/
  • 19.Marais L, Pernot M, Khettab H, et al. Arterial stiffnessassessment by shear wave elastography and ultrafast pulsewave imaging: comparison with reference techniques innormotensives and hypertensives. Ultrasound Med Biol2019;45(3):758-772. https://pubmed.ncbi.nlm.nih.gov/30642659/
  • 20.Lee HY, Oh BH. Aging and arterial stiffness. Circ J2010;74(11):2257-2262. https://pubmed.ncbi.nlm.nih.gov/20962429/
  • 21.Alis D, Durmaz ESM, Civcik C, et al. Assessment of the common carotid artery wall stiffness by shear wave elastography in Behcet's disease. Med Ultrason 2018;20(4):446-452. https://pubmed.ncbi.nlm.nih.gov/30534651/
  • 22.Yıldırım A, Karakaş MS, Kılınç AY, Altekin RE, Yalçınkaya AS. Evaluation of arterial stiffness and subclinicalatherosclerosis in patients with Behçet's disease without cardiovascular involvement. Turk Kardiyol Dern Ars. 2016Oct;44(7):575-581. https://pubmed.ncbi.nlm.nih.gov/27774966/
  • 23.Maffei S, Di Renzo M, Bova G, Auteri A, Pasqui AL.Takayasu's arteritis: a review of the literature. Intern Emerg Med. 2006;1(2):105-12. https://pubmed.ncbi.nlm.nih.gov/17111782/
  • 24.Keser G, Aksu K, Direskeneli H. Takayasu arteritis: an update. Turk J Med Sci 2018;48(4):681–697. https://pubmed.ncbi.nlm.nih.gov/30114347/
  • 25.Salvarani C, Cantini F, Boiardi L, Hunder GG. Laboratoryinvestigations useful in giant cell arteritis and Takayasu's arteritis. Clin Exp Rheumatol. 2003 Nov-Dec;21(6 Suppl 32):S23-8. https://pubmed.ncbi.nlm.nih.gov/14740424/
  • 26.Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford) 2013; 53:793-801. https://pubmed.ncbi.nlm.nih.gov/24097290/
  • 27.Muratore F, Pipitone N, Salvarani C, Schmidt WA. Imaging ofvasculitis: State of the art. Best Pract Res Clin Rheumatol. 2016 Aug;30(4):688-706. https://pubmed.ncbi.nlm.nih.gov/27931962/
  • 28.Schmidt WA, Nerenheim A, Seipelt E, Poehls C, Gromnica-Ihle E. Diagnosis of early Takayasu arteritis with sonography.Rheumatology (Oxford). 2002 May;41(5):496-502. https://pubmed.ncbi.nlm.nih.gov/12011371/
  • 29.Sun Y, Yip PK, Jeng JS, Hwang BS, Lin WH.Ultrasonographic study and long-term follow- up of Takayasu's arteritis. Stroke. 1996 Dec;27(12):2178-82. https://pubmed.ncbi.nlm.nih.gov/8969776/

Takayasu Arteritinde Karotis İntima Media Elastikiyetinin SWE ile Değerlendirilmesi

Yıl 2024, Cilt: 50 Sayı: 3, 457 - 462, 12.01.2025
https://doi.org/10.32708/uutfd.1534895

Öz

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.

Kaynakça

  • 1.Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002;55: 481-486.https://pubmed.ncbi.nlm.nih.gov/12101189/
  • 2.Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, MispiretaJ, Horwitz S, Vela JE. Takayasu's arteritis. Clinical study of107 cases. Am Heart J. 1977 Jan;93(1):94-103. https://pubmed.ncbi.nlm.nih.gov/12655/
  • 3.Andrews J, Mason JC. Takayasu’s arteritis—recent advances inimaging offer promise. Rheumatology (Oxford) 2007; 46:6.https://pubmed.ncbi.nlm.nih.gov/17043053/
  • 4.Dal Canto AJ, Virgin HW. Animal models of infectionmediated vasculitis. 4th ed. Curr Opin Rhematol 1999; 11:17-23. https://pubmed.ncbi.nlm.nih.gov/9894626/
  • 5.Direskeneli H, Aydin SZ, Merkel PA. Disease assessment inTakayasu's arteritis. Rheumatology (Oxford) 2013; 52:1735–1736. https://pubmed.ncbi.nlm.nih.gov/23955648/
  • 6.Lande A, Berkmen YM. Aortitis: pathologic, clinical, andarteriographic review. Radiol Clin North Am 1976; 14:219-240. https://pubmed.ncbi.nlm.nih.gov/9666/
  • 7.Alibaz-Oner F, Direskeneli H. Update on Takayasu’s arteritis.Presse Med 2015;44(Pt2): e259–e265. https://pubmed.ncbi.nlm.nih.gov/26033561/
  • 8.Andrews J, Al-Nahhas A, Pennell DJ, et al. Non-invasive imaging in the diagnosis and management of Takayasu’sarteritis. Ann Rheum Dis 2004; 63:995-1000. https://pubmed.ncbi.nlm.nih.gov/15249328/
  • 9.de Leeuw K, Bijl M, Jager PL. Additional value of positronemission tomography in diagnosis and follow-up of patientswith large vessel vasculitides. Clin Exp Rheumatol2004;22(Suppl 36): S21-S26. https://pubmed.ncbi.nlm.nih.gov/15675130/
  • 10.Bacon P, Direskeneli H. Quantifying disease involvement inTakayasu's arteritis. Rheumatology (Oxford) 2014; 53:1535–1536. https://pubmed.ncbi.nlm.nih.gov/24459218/
  • 11.Nicoletti G, Mannarella C, Nigro A, Sacco A, Olivieri I. The"Macaroni Sign" of Takayasu's arteritis. J Rheumatol. 2009 Sep;36(9):2042-3. https://pubmed.ncbi.nlm.nih.gov/19738209/
  • 12.Cosgrove D, Piscaglia F, Bamber J, et al. EFSUMB guidelinesand recommendations on the clinical use of ultrasoundelastography. Part 2: Clinical applications. Ultraschall in derMedizin 2013; 34:238-253. https://pubmed.ncbi.nlm.nih.gov/23605169/
  • 13.Ferraioli G, Tinelli C, Dal Bello B, et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronichepatitis C: a pilot study. Hepatology 2012; 56:2125-2133. https://pubmed.ncbi.nlm.nih.gov/22767302/
  • 14.Bond JR, Charboneau JW, Stanson AW. Takayasu’s arteritis:carotid duplex sonographic appearance, including colorDoppler imaging. J Ultrasound Med 1990; 9:625–629. https://pubmed.ncbi.nlm.nih.gov/1979636/
  • 15.Sun Y, Yip PK, Jeng JS, Hwang BS, Lin WH.Ultrasonographic study and long-term follow- up of Takayasu's arteritis. Stroke. 1996 Dec;27(12):2178-82. https://pubmed.ncbi.nlm.nih.gov/8969776/
  • 16.Maeda H, Nanda N, Matsumoto M, et al. Carotid lesionsdetected by B-mode ultrasonography in Takayasu’s arteritis: “macaroni sign” as an indicator of the disease. Ultrasound MedBiol 1991; 17:695–701. https://pubmed.ncbi.nlm.nih.gov/1685816/
  • 17.Thomas L, Low J, Chan K, Durbridge G. Shear waveelastography of the cervical arteries: A novel approach to theassessment of cervical arterial wall stiffness. An investigationof psychometric properties and intra-rater reliability.Musculoskelet Sci Pract. 2019 Apr; 40:96-100. https://pubmed.ncbi.nlm.nih.gov/30262424/
  • 18.Thomas LC, Chan K, Durbridge G. Changes in internal carotid and vertebral arterial wall stiffness with head movement can bedetected with shear wave elastography. J Man Manip Ther2020;28(2):103-110. https://pubmed.ncbi.nlm.nih.gov/31663837/
  • 19.Marais L, Pernot M, Khettab H, et al. Arterial stiffnessassessment by shear wave elastography and ultrafast pulsewave imaging: comparison with reference techniques innormotensives and hypertensives. Ultrasound Med Biol2019;45(3):758-772. https://pubmed.ncbi.nlm.nih.gov/30642659/
  • 20.Lee HY, Oh BH. Aging and arterial stiffness. Circ J2010;74(11):2257-2262. https://pubmed.ncbi.nlm.nih.gov/20962429/
  • 21.Alis D, Durmaz ESM, Civcik C, et al. Assessment of the common carotid artery wall stiffness by shear wave elastography in Behcet's disease. Med Ultrason 2018;20(4):446-452. https://pubmed.ncbi.nlm.nih.gov/30534651/
  • 22.Yıldırım A, Karakaş MS, Kılınç AY, Altekin RE, Yalçınkaya AS. Evaluation of arterial stiffness and subclinicalatherosclerosis in patients with Behçet's disease without cardiovascular involvement. Turk Kardiyol Dern Ars. 2016Oct;44(7):575-581. https://pubmed.ncbi.nlm.nih.gov/27774966/
  • 23.Maffei S, Di Renzo M, Bova G, Auteri A, Pasqui AL.Takayasu's arteritis: a review of the literature. Intern Emerg Med. 2006;1(2):105-12. https://pubmed.ncbi.nlm.nih.gov/17111782/
  • 24.Keser G, Aksu K, Direskeneli H. Takayasu arteritis: an update. Turk J Med Sci 2018;48(4):681–697. https://pubmed.ncbi.nlm.nih.gov/30114347/
  • 25.Salvarani C, Cantini F, Boiardi L, Hunder GG. Laboratoryinvestigations useful in giant cell arteritis and Takayasu's arteritis. Clin Exp Rheumatol. 2003 Nov-Dec;21(6 Suppl 32):S23-8. https://pubmed.ncbi.nlm.nih.gov/14740424/
  • 26.Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford) 2013; 53:793-801. https://pubmed.ncbi.nlm.nih.gov/24097290/
  • 27.Muratore F, Pipitone N, Salvarani C, Schmidt WA. Imaging ofvasculitis: State of the art. Best Pract Res Clin Rheumatol. 2016 Aug;30(4):688-706. https://pubmed.ncbi.nlm.nih.gov/27931962/
  • 28.Schmidt WA, Nerenheim A, Seipelt E, Poehls C, Gromnica-Ihle E. Diagnosis of early Takayasu arteritis with sonography.Rheumatology (Oxford). 2002 May;41(5):496-502. https://pubmed.ncbi.nlm.nih.gov/12011371/
  • 29.Sun Y, Yip PK, Jeng JS, Hwang BS, Lin WH.Ultrasonographic study and long-term follow- up of Takayasu's arteritis. Stroke. 1996 Dec;27(12):2178-82. https://pubmed.ncbi.nlm.nih.gov/8969776/
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Başak Erdemli Gürsel 0000-0002-0047-1780

Sedat Giray Kandemirli 0000-0002-3976-4062

İlker Ercan 0000-0002-2382-290X

Burcu Yağız 0000-0002-0624-1986

Yavuz Pehlivan 0000-0002-1201-8836

Naile Bolca Topal 0000-0002-4821-242X

Yayımlanma Tarihi 12 Ocak 2025
Gönderilme Tarihi 17 Ağustos 2024
Kabul Tarihi 25 Kasım 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 50 Sayı: 3

Kaynak Göster

APA Erdemli Gürsel, B., Kandemirli, S. G., Ercan, İ., Yağız, B., vd. (2025). Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 50(3), 457-462. https://doi.org/10.32708/uutfd.1534895
AMA Erdemli Gürsel B, Kandemirli SG, Ercan İ, Yağız B, Pehlivan Y, Bolca Topal N. Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography. Uludağ Tıp Derg. Ocak 2025;50(3):457-462. doi:10.32708/uutfd.1534895
Chicago Erdemli Gürsel, Başak, Sedat Giray Kandemirli, İlker Ercan, Burcu Yağız, Yavuz Pehlivan, ve Naile Bolca Topal. “Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50, sy. 3 (Ocak 2025): 457-62. https://doi.org/10.32708/uutfd.1534895.
EndNote Erdemli Gürsel B, Kandemirli SG, Ercan İ, Yağız B, Pehlivan Y, Bolca Topal N (01 Ocak 2025) Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50 3 457–462.
IEEE B. Erdemli Gürsel, S. G. Kandemirli, İ. Ercan, B. Yağız, Y. Pehlivan, ve N. Bolca Topal, “Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography”, Uludağ Tıp Derg, c. 50, sy. 3, ss. 457–462, 2025, doi: 10.32708/uutfd.1534895.
ISNAD Erdemli Gürsel, Başak vd. “Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50/3 (Ocak 2025), 457-462. https://doi.org/10.32708/uutfd.1534895.
JAMA Erdemli Gürsel B, Kandemirli SG, Ercan İ, Yağız B, Pehlivan Y, Bolca Topal N. Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography. Uludağ Tıp Derg. 2025;50:457–462.
MLA Erdemli Gürsel, Başak vd. “Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 50, sy. 3, 2025, ss. 457-62, doi:10.32708/uutfd.1534895.
Vancouver Erdemli Gürsel B, Kandemirli SG, Ercan İ, Yağız B, Pehlivan Y, Bolca Topal N. Evaluation of Carotid Artery Intima Media Elasticity in Takayasu Arteritis by Shear Wave Elastography. Uludağ Tıp Derg. 2025;50(3):457-62.

ISSN: 1300-414X, e-ISSN: 2645-9027

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