Role of Contrast-Enhanced Ultrasound Sonography in the Medical Diagnostics of the Disease Activity in Patients With Takayasu Arteritis

Abstract

The accurate diagnosis of Takayasu arteritis (TA) and the evaluation of its activity can bring significant challenges. In this paper, we sought to investigate a correlation between clinical activity and the enhancement of vessel wall acquired by contrast-enhanced ultrasound sonography (CEUS) in patients with TA, and to evaluate whether CEUS can be used to assess the disease activity of TA. Twenty TA patients with their carotid arteries affected were enrolled and divided into the active group and the inactive group according to the NIH scoring method. The white blood cell counts, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were obtained. Conventional ultrasound was performed to acquire the external diameter of the artery (D), intima-media thickness of the arterial wall (IMT), percent area stenosis, peak systolic velocity, end diastolic velocity, and resistance index. CEUS was performed to acquire the enhanced intensity (EI), derived peak intensity (DPI), and time to peak. The analysis showed that compared with the inactive group, D and IMT were significantly higher in the active group ( $6.50~\pm ~1.80$ versus $9.20~\pm ~4.00$ mm, $1.80~\pm ~0.40$ versus $2.40~\pm ~0.70$ mm, $p ). EI and DPI were also significantly higher in the active group ( $38.20~\pm ~10.62$ versus $80.80~\pm ~23.60$ IU, $46.20~\pm ~10.20$ versus $90.30~\pm ~24.60$ IU, $p ). Meanwhile, EI and DPI showed good correlation with CRP and ESR. Therefore, our study demonstrated that CEUS can increase the effectiveness of conventional ultrasound in differentiating active and inactive TA.