title: Pulmonary perfusion scintigraphy: a tool to detect the presence of pulmonary artery involvement in Takayasu's arteritis.
abstract: OBJECTIVE
  Takayasu arteritis (TA) is a large-vessel vasculitis that can also involve pulmonary arteries. The aim of this study was to evaluate the frequency of pulmonary artery involvement in TA patients using pulmonary perfusion scintigraphy (PPS) and to determine the characteristics of patients with pulmonary artery involvement.
  
  
  METHODS
  Twenty-one patients classified as having TA underwent PPS. PPS positivity was defined as the presence of perfusion defects with normal ventilation. TA diagnosis was assessed using American College of Rheumatology (ACR) and/or Ishikawa's modified criteria.
  
  
  RESULTS
  Twenty-one patients (median age 36 years [range; 21-78]; 18 females) were analyzed. PPS was positive in 12 (57%) patients. Pulmonary symptoms were present in 4/12 patients with positive PPS, but none in patients with negative PPS. Among the 12 patients with positive PPS, eight patients (67%) were asymptomatic with regard to pulmonary involvement. No difference was noted between patients with positive and negative PPS with respect to general characteristics, vascular involvement, biological parameters or treatment regimen. PPS sensitivity was 100%, specificity at 53% and predictive negative value at 100% in patients with TA relative to the presence of pulmonary symptoms.
  
  
  CONCLUSIONS
  Although frequent, pulmonary artery involvement in TA is often asymptomatic. Its systematic detection by PPS could be valuable in the diagnosis of TA.
authors.affiliation: Internal Medicine Department, Claude Huriez Hospital, 59037 Lille, France.
authors.forename: Arsene
authors.initials: A
authors.lastname: Mekinian
authors.forename: Marc
authors.initials: M
authors.lastname: Lambert
authors.forename: Damien
authors.initials: D
authors.lastname: Huglo
authors.forename: Patrick
authors.initials: P
authors.lastname: Devos
authors.forename: Tristan
authors.initials: T
authors.lastname: Mirault
authors.forename: Marc
authors.initials: M
authors.lastname: Steinling
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Hatron
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D055420:Perfusion Imaging; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000150:complications* / Q000000981:diagnostic imaging*; D055815:Young Adult