Background Conventional angiography is the diagnostic imaging criteria in 1990 ACR Takayasu Arteritis (TA) Classification Criteria. In recent years, non-invasive imaging methods such as Doppler Ultrasonography (Doppler US), Computerized Tomography Angiography (CT-Ang) and Magnetic Resonance Angiography (MR-Ang) are frequently used in diagnosis and/or follow up in TA. However, studies investigating optimal timing of follow up imaging are rare.1
Objectives This study is aimed to investigate the radiologic changes in vessel involvements of TA patients approximately 1-year after diagnosis.
Methods Database of our Vasculitis Center is retrospectively analyzed and 97 (Female/Male: 90/7) TA patients were included into the study. Demographic, clinical, radiological and therapeutic findings of patients were recorded. Patients with the same imaging method after one year of diagnosis were recruited into the further analysis. Radiological changes in the involved vessels were investigated (Doppler US, CT-Ang, MR-Ang). The effect of different immunosuppressive agents on vessel involvement changes were also studied.
Results Mean ages and disease duration of patients were 43.0 (14.4) and 9.0 (5.1) years, respectively. Subclavian arteries and common carotid arteries were the most frequent involved vessels. All patients were on corticosteroid therapy and additional immunosuppressive agent. Most frequent initial immunosuppressive agents were methotrexate (n=35), cyclophosphamide (n=33), and azathioprine (n=20). Totally 13 (13.4%) patients had been treated with biologic therapies during all follow up.
Fifty patients had a follow-up imaging with the same modality at 12±3 months. Sixty-eight percent of patients had stabile vessel involvements whereas 28% had progression and 4% had regression. No difference was found in radiological changes regarding patients with usage of different immunosuppressive agents (p=0.634). Table 1 shows the comparison of the diagnostic accuracy, coefficient of agreement and AUC results of 4 criteria.
Conclusions Follow-up imaging modalities were investigated in a larger TA patient group than previous studies.1 Almost 30% of TA patients in our Vasculitis center had progression in follow up imaging. This finding was concordant with previous literature. A follow up imaging at around 1-year of treatment, seems feasible in management of TA patients.
Mavrogeni S et al. The role of multimodalityimaging in the Evaluation of TakayasuArteritis. Sem ArthRheum 2013;42:401-412.
Disclosure of Interest None declared