IMR Press / RCM / Volume 23 / Issue 3 / DOI: 10.31083/j.rcm2303092
Open Access Original Research
Comparison of Different Thoracic Aortic Wall Characteristics for Assessment of Disease Activity in Takayasu Arteritis: A Quantitative Study with 3.0 T Magnetic Resonance Imaging
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1 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China
2 Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
3 Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
4 Department of Radiology, The Seventh Affiliated Hospital of Sun Yat-sen University, 518038 Shenzhen, Guangdong, China
5 Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, 6845 Perth, Australia
6 Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, 6845 Perth, Australia
*Correspondence: Z.Sun@curtin.edu.au (Zhonghua Sun); cjr.wzhch@vip.163.com (Zhenchang Wang)
Academic Editor: Carmela Rita Balistreri
Rev. Cardiovasc. Med. 2022, 23(3), 92; https://doi.org/10.31083/j.rcm2303092
Submitted: 15 January 2022 | Revised: 11 February 2022 | Accepted: 16 February 2022 | Published: 9 March 2022
(This article belongs to the Special Issue New insight in Cardiovascular Imaging)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

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.

Keywords
takayasu arteritis
magnetic resonance imaging
4D-flow
PWV
aorta
Figures
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