TY - JOUR
T1 - Comparison of Different Thoracic Aortic Wall Characteristics for Assessment of Disease Activity in Takayasu Arteritis
T2 - A Quantitative Study with 3.0 T Magnetic Resonance Imaging
AU - Zhang, Nan
AU - Pan, Lili
AU - Liu, Jiayi
AU - Li, Yu
AU - Xu, Lei
AU - Sun, Zhonghua
AU - Wang, Zhenchang
N1 - Publisher Copyright:
Copyright: © 2022 The Author(s). Published by IMR Press. This is an open access article under the CC BY 4.0 license.
PY - 2022
Y1 - 2022
N2 - Background: Determination of disease activity in Takayasu arteritis (TAK) is crucial for clinical management but challenging. The value of different magnetic resonance imaging (MRI) characteristics for the assessment of disease activity remains unclear. This study investigated the imaging findings of the thoracic aortic wall and elasticity by using a comprehensive 3.0 T MRI protocol. Methods: We prospectively enrolled 52 consecutive TAK patients. TAK activity was recorded according to the ITAS2010. All the patients underwent thoracic aortic MRI. The luminal morphology of the thoracic aorta and its main branches were quantitatively evaluated using a contrast-enhanced magnetic resonance angiography (MRA) sequence. The maximum wall thickness of the thoracic aorta, postcontrast enhancement ratio, and aortic wall edema were analyzed in each patient through pre- and post-enhanced T1-weighted and T2-weighted imaging. Pulse-wave velocity (PWV) of the thoracic aorta was calculated using a four-dimensional flow technique. Results: The majority of the 52 patients had type V disease (34.62%, 18/52). Among all the MRI indicators of the thoracic aorta, the area under the curve was the largest for the maximal wall thickness (0.804, 95% confidence interval [CI] = 0.667–0.941). The maximal wall thickness (93.33%, 95% CI = 68.1%–99.8%) exhibited the highest sensitivity with a cutoff value of 3.12 mm. Wall edema (84.00%, 95% CI = 63.9%–95.5%) presented the highest specificity. A positive correlation was noted between PWV and patients’ age (r = 0.54, p < 0.001), disease duration (r = 0.52, p < 0.001), and the maximum wall thickness (r = 0.45, p = 0.001). Conclusions: MRI enabled the comprehensive assessment of aortic wall morphology and functional markers for TAK disease activity. Aortic maximal wall thickness was the most accurate indicator of TAK activity. The early phase was superior to the delay phase for aortic wall enhancement analysis for assessing TAK activity.
AB - Background: Determination of disease activity in Takayasu arteritis (TAK) is crucial for clinical management but challenging. The value of different magnetic resonance imaging (MRI) characteristics for the assessment of disease activity remains unclear. This study investigated the imaging findings of the thoracic aortic wall and elasticity by using a comprehensive 3.0 T MRI protocol. Methods: We prospectively enrolled 52 consecutive TAK patients. TAK activity was recorded according to the ITAS2010. All the patients underwent thoracic aortic MRI. The luminal morphology of the thoracic aorta and its main branches were quantitatively evaluated using a contrast-enhanced magnetic resonance angiography (MRA) sequence. The maximum wall thickness of the thoracic aorta, postcontrast enhancement ratio, and aortic wall edema were analyzed in each patient through pre- and post-enhanced T1-weighted and T2-weighted imaging. Pulse-wave velocity (PWV) of the thoracic aorta was calculated using a four-dimensional flow technique. Results: The majority of the 52 patients had type V disease (34.62%, 18/52). Among all the MRI indicators of the thoracic aorta, the area under the curve was the largest for the maximal wall thickness (0.804, 95% confidence interval [CI] = 0.667–0.941). The maximal wall thickness (93.33%, 95% CI = 68.1%–99.8%) exhibited the highest sensitivity with a cutoff value of 3.12 mm. Wall edema (84.00%, 95% CI = 63.9%–95.5%) presented the highest specificity. A positive correlation was noted between PWV and patients’ age (r = 0.54, p < 0.001), disease duration (r = 0.52, p < 0.001), and the maximum wall thickness (r = 0.45, p = 0.001). Conclusions: MRI enabled the comprehensive assessment of aortic wall morphology and functional markers for TAK disease activity. Aortic maximal wall thickness was the most accurate indicator of TAK activity. The early phase was superior to the delay phase for aortic wall enhancement analysis for assessing TAK activity.
KW - 4D-flow
KW - PWV
KW - aorta
KW - magnetic resonance imaging
KW - takayasu arteritis
UR - http://www.scopus.com/inward/record.url?scp=85127264712&partnerID=8YFLogxK
U2 - 10.31083/j.rcm2303092
DO - 10.31083/j.rcm2303092
M3 - Article
C2 - 35345259
AN - SCOPUS:85127264712
SN - 1530-6550
VL - 23
JO - Reviews in Cardiovascular Medicine
JF - Reviews in Cardiovascular Medicine
IS - 3
M1 - 23
ER -