Takayasu 动脉炎疾病活动度评估：一项基于 CT 血管造影的定量研究。

Assessment of disease activity in Takayasu arteritis: A quantitative study with computed tomography angiography.

机构信息

Department of Radiology, Shandong Provincial Hospital, Key Laboratory of Diagnosis and Treatment of Cardio-cerebral Vascular Diseases, Shandong University, #324, Jingwu Road, Jinan, Shandong 250021, PR China; Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Xi-Cheng District, Beijing 100037, PR China.

出版信息

Int J Cardiol. 2019 Aug 15;289:144-149. doi: 10.1016/j.ijcard.2019.04.086. Epub 2019 May 2.

DOI:10.1016/j.ijcard.2019.04.086

PMID:31079971

Abstract

BACKGROUND

Identifying disease activity in Takayasu arteritis (TAK) is challenging. This study aimed to investigate the value of quantitative characterization with computed tomography angiography in the assessment of disease activity in patients with TAK.

METHODS

We retrospectively analysed the data on 162 aortic CT angiography from 140 TAK patients. Patients were categorized based on disease activity according to the National Institutes of Health criteria into two groups: active disease group (n = 65) and inactive disease group (n = 97).

RESULTS

Patients with active TAK had a thicker wall compared with patients with inactive TAK (5.2 ± 2.4 mm vs. 2.5 ± 0.8 mm, p < 0.001). The relative post-contrast enhancement ratio of the thickened wall was higher in active TAK than in inactive TAK (1.5 ± 0.3 vs. 1.1 ± 0.2, p < 0.001). Given a thickness cutoff of 3.3 mm, sensitivity for active-phase TAK was 83.1%, specificity 89.7%, positive predictive value 84.4%, and negative predictive value 88.8%. With a relative post-contrast enhancement ratio cutoff of 1.2, sensitivity for active-phase TAK was 89.2%, specificity 76.3%, positive predictive value 71.6%, and negative predictive value 91.3%. In receiver-operating characteristic curves comparison, maximal wall thickness and relative post-contrast enhancement ratio were superior to C-reactive protein and erythrocyte sedimentation rate for determining active phase disease (p < 0.05).

CONCLUSIONS

Quantitative characterization with CT angiography was a useful tool to assess disease activity in TAK patients. Maximal wall thickness and relative post-contrast enhancement ratio have a high sensitivity and specificity for detecting TAK activity.

摘要

背景

大动脉炎（TAK）疾病活动的识别具有挑战性。本研究旨在探讨 CT 血管造影定量特征在 TAK 患者疾病活动评估中的价值。

方法

我们回顾性分析了 140 例 TAK 患者的 162 例主动脉 CT 血管造影数据。根据 NIH 标准，根据疾病活动将患者分为两组：活动期疾病组（n=65）和非活动期疾病组（n=97）。

结果

与非活动期 TAK 相比，活动期 TAK 患者的血管壁更厚（5.2±2.4mm 比 2.5±0.8mm，p<0.001）。活动期 TAK 增厚壁的相对增强后比值高于非活动期 TAK（1.5±0.3 比 1.1±0.2，p<0.001）。当厚度截断值为 3.3mm 时，活动期 TAK 的敏感性为 83.1%，特异性为 89.7%，阳性预测值为 84.4%，阴性预测值为 88.8%。当相对增强后比值截断值为 1.2 时，活动期 TAK 的敏感性为 89.2%，特异性为 76.3%，阳性预测值为 71.6%，阴性预测值为 91.3%。在受试者工作特征曲线比较中，最大壁厚度和相对增强后比值优于 C 反应蛋白和红细胞沉降率，用于确定活动期疾病（p<0.05）。