title: Contrast-enhanced ultrasonography in Takayasu arteritis: watching and monitoring the arterial inflammation.
abstract: A 43-year-old man was diagnosed with Takayasu arteritis, and treated with methotrexate and corticosteroids. While under treatment and with normal biological inflammatory parameters, he experienced an ischaemic stroke, successfully treated with intravenous thrombolysis (alteplase). The B-mode ultrasound examination revealed circumferential wall thickening of the left common carotid artery. Contrast-enhanced ultrasonography showed a progressive arterial wall enhancement of the left common carotid artery. This pathological enhancement indicates neovascularisation of the arterial wall, which is supposed to correlate with active vascular inflammation. After an increase in immunosuppressive treatment, follow-up contrast-enhanced ultrasonography no longer showed artery wall enhancement. Contrast-enhanced ultrasound examination is an inexpensive, reproducible and minimally invasive method, providing dynamic information on arterial wall neovascularisation and thus inflammation. This case illustrates that contrast-enhanced ultrasonography can be a useful tool for the management and follow-up of Takayasu arteritis, and its use as a marker of disease activity and arterial inflammation in Takayasu arteritis should be evaluated in further studies.
authors.affiliation: Department of Neurology and Stroke Center, Versailles Saint Quentin en Yvelines University, Centre Hospitalier de Versailles, Versailles, France.
authors.forename: Bastien
authors.initials: B
authors.lastname: Herlin
authors.affiliation: Angiology and Ultrasound Unit, Centre Hospitalier de Versailles, Versailles, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Baud
authors.affiliation: Department of Neurology and Stroke Center, Versailles Saint Quentin en Yvelines University, Centre Hospitalier de Versailles, Versailles, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Chadenat
authors.affiliation: Department of Neurology and Stroke Center, Versailles Saint Quentin en Yvelines University, Centre Hospitalier de Versailles, Versailles, France.
authors.forename: Fernando
authors.initials: F
authors.lastname: Pico
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D003287:Contrast Media; D019468:Disease Management; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy; D013625:Takayasu Arteritis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones; D003287:Contrast Media; D010959:Tissue Plasminogen Activator; D008727:Methotrexate