Maurizio Papa MD, Presenter: Nothing to Disclose

Francesco Aldo De Cobelli MD, Abstract Co-Author: Nothing to Disclose

Elena Baldissera, Abstract Co-Author: Nothing to Disclose

Elena Schiani MD, Abstract Co-Author: Nothing to Disclose

Maria Grazia Sabbadini MD, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

Presently the evaluation of disease activity is a medical challenge. The correct and well-timed assessment of disease activitiy has relevant therapeutic implications; however this definition is based only on clinical ground features. In order to image the vascular inflammation we sought to investigate the thickened vessel wall enhancement in active and non active-phase Takayasu’s Disease using contrast enhanced ultrasound with SONOVUE®.

9 patients with active-phase and 2 patient with non-active-phase Takayasu’s arteritis underwent Duplex-scan of supra-aortic trunks and visceral vessels completed with intravenous SONOVUE injection targeting the probe on the vessel with most chances to show active disease. A dedicated software to objectify the results was used. The selection of the vessel has been done considering the thickness and, more important, the clinical ongoing symptoms and imaging worsening.  

In the active-disease group 12 significant stenosis and 3 occlusions were found, while in the non-active patient no stenosis and 2 old occlusions were detected. In all the 9 patients with active-phase disease a progressive and significant enhancement of the thickened vessel wall was found. While in the non-active disease group non significant vessel wall enhancement was found, even if thickened.

Our results show that in patients with active-phase disease an increased vascularization of the thickened vessel wall involved by the disease was observed, while no significant enhancement was found in the non-active disease group thickenings. This enhancement in the active-disease group can be considered the sonographic expression of the adventitia’s layer inflammation in Takayasu’s patients with disease at active-phase. The patients at a non-active disease phase had no wall enhancement, even in case of wall thickening, expression of an old, fibrotic and presently non-active disease.

This study shows how a simple and cheap tecnique can give important informations on disease activity in patients with previous diagnosis of TA and to follow them up during therapy administration.

Papa, M, De Cobelli, F, Baldissera, E, Schiani, E, Sabbadini, M, Del Maschio, A, Evaluation of Vessel Wall Enhancement in Active and Non-active Phase Takayasu’s Disease (TA) with Ultrasound Contrast Media.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011700.html