From the Department of Radiology and Cardiovascular Imaging Center (E.J.K., S.M.K., Y.H.C.), Department of Internal Medicine, Division of Cardiology and Cardiovascular Imaging Center (G.Y.L., D.K.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710, Republic of Korea; and Department of Radiology, Dong-A University College of Medicine, Busan, Republic of Korea (E.J.K., K.N.L.).
Radiology. 2014 Jan;270(1):74-81. doi: 10.1148/radiol.13122195. Epub 2013 Oct 28.
To evaluate coronary arterial lesions and to assess their correlation with clinical findings in patients with Takayasu arteritis (TA) by using coronary computed tomographic (CT) angiography.
This retrospective study was approved by the hospital internal review board, and informed consent was waived. A total of 111 consecutive patients with TA (97 female, 14 male; mean age, 44 years ± 13.8 [standard deviation]; age range, 14-74 years) underwent CT angiography of the coronary arteries and aorta with 128-section dual-source CT. CT angiographic, clinical, and laboratory findings of each patient were retrospectively reviewed. Statistical differences between coronary CT angiographic findings and clinical parameters were examined with univariate analysis.
Of 111 patients, 32 (28.8%) had cardiac symptoms and the remaining 79 (71.2%) had no cardiac symptoms. Fifty-nine patients (53.2%) had coronary arterial lesions at coronary CT angiography. Three main radiologic features were detected: coronary ostial stenosis (n = 31, 28.0%), nonostial coronary arterial stenosis (n = 41, 36.9%), and coronary aneurysm (n = 9, 8.1%). Coronary artery ostial or luminal stenosis of 50% or more or coronary aneurysms were observed in 26 (23.4%) patients with TA. Patients with coronary arterial abnormalities at coronary CT angiography had higher incidences of hypertension (P = .02), were older at the time of CT (P = .01), and had longer duration of TA (P = .02) than those without coronary artery abnormalities. The presence of cardiac symptoms, disease activity, and other comorbidities was not associated with differences in coronary artery involvement.
In patients with TA, there is a high prevalence of coronary arterial abnormalities at coronary CT angiography, regardless of disease activity or symptoms. Thus, coronary CT angiography may add information on coronary artery lesions in patients with TA.
通过冠状动脉计算机断层扫描（CT）血管造影术评估大动脉炎（TA）患者的冠状动脉病变，并评估其与临床发现的相关性。
本回顾性研究获得了医院内部审查委员会的批准，并豁免了知情同意。共对 111 例连续的 TA 患者（97 例女性，14 例男性；平均年龄 44 岁±13.8[标准差]；年龄范围 14-74 岁）进行了冠状动脉和主动脉 128 层双源 CT 血管造影检查。回顾性分析每位患者的 CT 血管造影、临床和实验室检查结果。采用单因素分析比较冠状动脉 CT 血管造影结果与临床参数的差异。
111 例患者中有 32 例（28.8%）有心脏症状，其余 79 例（71.2%）无心脏症状。59 例（53.2%）患者在冠状动脉 CT 血管造影中存在冠状动脉病变。发现 3 种主要影像学特征：冠状动脉开口狭窄（n=31，28.0%）、非开口冠状动脉狭窄（n=41，36.9%）和冠状动脉瘤（n=9，8.1%）。26 例（23.4%）TA 患者观察到冠状动脉开口或管腔狭窄≥50%或冠状动脉瘤。在冠状动脉 CT 血管造影中存在冠状动脉异常的患者中，高血压的发生率更高（P=0.02），CT 时年龄更大（P=0.01），TA 病程更长（P=0.02）。是否存在心脏症状、疾病活动度和其他合并症与冠状动脉受累无差异。
在 TA 患者中，冠状动脉 CT 血管造影显示冠状动脉异常的发生率较高，无论疾病活动度或症状如何。因此，冠状动脉 CT 血管造影可能为 TA 患者提供冠状动脉病变的信息。
