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应用对比增强磁共振成像评估大动脉炎的活动度。

Evaluation of Takayasu arteritis activity by delayed contrast-enhanced magnetic resonance imaging.

机构信息

Department of Rheumatology, Zhongshan Hospital, Fudan University, China.

出版信息

Int J Cardiol. 2012 Mar 8;155(2):262-7. doi: 10.1016/j.ijcard.2010.10.002. Epub 2010 Nov 6.

Abstract

BACKGROUND

To measure and assess the disease activity of Takayasu arteritis (TA) quantitatively by magnetic resonance angiography (MRA).

METHODS

Twenty-six Chinese TA patients were divided into an active group and an inactive group. All patients underwent delayed contrast-enhanced MRI. The vessels involved were categorized into type A (main branches of aorta and its arch) and type B (secondary or tertiary branches). Three quantitative scores were defined to gauge lumen stenosis, vessel wall thickness, and vessel wall enhancement, and compared between groups and types.

RESULTS

The patients in the active group had more stenosis in left subclavian artery than those in the inactive group (14/16, 87.5% vs. 2/10, 20%; p<0.01), and greater vessel wall thickness in left common carotid artery (11/16, 68.75% vs. 1/10, 10%; p<0.01) and left subclavian artery (9/16, 56.25% vs. 0/10, 0%; p<0.01). The differences between active and inactive TA were significant in type A (lumen stenosis: 11.13 ± 6.17 vs. 4.00 ± 4.32; p<0.001; wall thickness: 8.00 ± 5.05 vs. 3.10 ± 3.31; p=0.01; wall enhancement: 6.94 ± 5.34 vs. 2.90 ± 4.36; p=0.05), and pronounced in type A+B (lumen stenosis: 13.31 ± 7.19 vs. 6.30 ± 5.60; p=0.02; wall thickness: 8.50 ± 5.29 vs. 3.40 ± 3.34; p=0.01; wall enhancement: 7.94 ± 6.55 vs. 3.20 ± 4.32, p=0.05, respectively). These three scores were moderately correlated to CRP, platelet count and fibrinogen levels (p<0.05).

CONCLUSIONS

The MRI scoring system of lumen stenosis, wall thickness and wall enhancement could be a non-invasive approach to facilitate assessment in TA activity.

摘要

背景

通过磁共振血管成像(MRA)来测量和评估 Takayasu 动脉炎(TA)的疾病活动程度。

方法

26 例中国 TA 患者被分为活动组和非活动组。所有患者均行延迟对比增强 MRI。将受累血管分为 A 型(主动脉及其弓主要分支)和 B 型(二级或三级分支)。定义了三个定量评分标准,以评估管腔狭窄、血管壁厚度和血管壁增强程度,并比较了组间和类型间的差异。

结果

活动组患者左锁骨下动脉狭窄程度大于非活动组(14/16,87.5%比 2/10,20%;p<0.01),左颈总动脉(11/16,68.75%比 1/10,10%;p<0.01)和左锁骨下动脉(9/16,56.25%比 0/10,0%;p<0.01)的血管壁厚度也更大。A型(管腔狭窄:11.13 ± 6.17 比 4.00 ± 4.32;p<0.001;壁厚度:8.00 ± 5.05 比 3.10 ± 3.31;p=0.01;壁增强:6.94 ± 5.34 比 2.90 ± 4.36;p=0.05)和 A+B 型(管腔狭窄:13.31 ± 7.19 比 6.30 ± 5.60;p=0.02;壁厚度:8.50 ± 5.29 比 3.40 ± 3.34;p=0.01;壁增强:7.94 ± 6.55 比 3.20 ± 4.32;p=0.05)的差异在活动 TA 中更为显著。这三个评分与 CRP、血小板计数和纤维蛋白原水平中度相关(p<0.05)。

结论

管腔狭窄、壁厚度和壁增强的 MRI 评分系统可能是一种非侵入性的评估 TA 活动的方法。

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