Ultrasonography in the quantification of arterial involvement in Takayasu's arteritis.

OBJECTIVE: To evaluate the accuracy of ultrasonography (US) in the detection and quantification of arterial involvement in Takayasu's arteritis (TA). METHODS: The common carotid and subclavian arteries, and the abdominal aorta of 15 patients with TA were studied by Color Doppler (CD) US and Doppler spectral analysis and compared with angiography. RESULTS: The mean difference (+/-SD) between the percent luminal stenoses measured at angiography and by CD US was 2.0+/-10.3% for the common carotid artery, 4.0+/-23.6% for the subclavian artery and -1.3+/-16.8% for the abdominal aorta. The differences were not statistically significant. However, the agreement of the methods was less than satisfactory as shown by the wide standard deviations. CONCLUSIONS: More efforts are needed to improve the less than optimal agreement of US with angiography regarding the severity of individual stenoses. The technique performs best in the study of carotid arteries.

Graft patency evaluation with colour-Doppler ultrasonography after bypass surgery in Takayasu's arteritis: a direct colour-flow lumen imaging method.

OBJECTIVES: To assess the feasibility and potential diagnostic usefulness of colour-Doppler flow imaging (CDFI) to detect complications of supra-aortic vascular bypass grafts in Takayasu's arteritis (TA). DESIGN: A prospective study. MATERIALS: Nine supra-aortic grafts in six patients with Takayasu's arteritis. METHODS: The minimal, maximal, and true colour-flow image diameters of the lumens of the grafts were measured and stenoses, occlusions, and dilatations were evaluated and compared with angiographic findings. RESULTS: The sensitivity for detection in > 50% stenoses and in total occlusions was 75% while specificity was 100%. Only one 40% stenosis had been overlooked in whole. The maximal difference of stenosis by two methods was otherwise 20%. CONCLUSIONS: CDFI was in general able to expose stenoses in supra-aortic grafts, but the lack of visibility of some grafts throughout their length cause the false results. It appears that some angiographies can be replaced by CDFI and that this is a suitable method for follow-up in symptom-free patients with grafts.

Arterial wall thickness measurements by B mode ultrasonography in patients with Takayasu's arteritis.

OBJECTIVE: To assess the feasibility and potential diagnostic usefulness of arterial ultrasonography in Takayasu's arteritis. METHODS: The total wall, intimal + medial, and adventitial thickness of the common carotid, subclavian and common femoral arteries, and of the abdominal aorta, were examined by B mode ultrasonography in 16 patients with Takayasu's arteritis and 16 healthy control subjects. RESULTS: The mean total wall and intimal + medial thickness of all arteries other than the common femoral were significantly increased in Takayasu's arteritis. Long segments of homogeneous circumferential wall thickening in multiple vessels were characteristic. When the common carotid and subclavian arteries and the abdominal aorta were examined, each individual with Takayasu's arteritis had at least one artery with total wall thickness exceeding the reference range in controls. CONCLUSIONS: B mode ultrasonography is able to expose the widespread arterial wall thickening characteristic of Takayasu's arteritis and may provide a useful tool for the detection and follow up of this disease.