title: Contrast-Enhanced Ultrasound of the Carotid Artery in Patients With Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings.
abstract: To assess the findings of contrast-enhanced ultrasound (CEUS) of carotid arteries in patients with large vessel vasculitis (LVV) and to compare them with those observed using18F-fluorodeoxyglucose-positron emission tomography (18FDG-PET).
  
  
  
  A total of 31 consecutive patients with LVV (14 with Takayasu arteritis, 17 with giant cell arteritis with large vessel involvement) underwent both PET/computed tomography and carotid artery color Doppler ultrasound (CDUS) for a total of 35 combined assessments. Right carotid artery CEUS was performed after CDUS in all assessments. Kerr's criteria, a complete clinical examination, and acute phase reactants were simultaneously evaluated. The intensity of vascular uptake and vascularization of the carotid artery wall were compared.
  
  
  
  Ten18F-FDG/PET scans showed active vascular18F-FDG uptake (visual grade ≥2) in the right carotid artery. CEUS demonstrated severe vascularization (grade 2) within the right carotid artery wall in 12 examinations. The carotid CEUS vascularization grade significantly correlated with vascular18F-FDG uptake (P < 0.001) and maximum standardized uptake value (SUV) in the right carotid artery/mean SUV in the superior vena cava (P = 0.001). When active vascular18F-FDG uptake (≥2) was considered the gold standard for defining vascular inflammation, carotid CEUS had a sensitivity of 100% (95% confidence interval [95% CI] 65-100) and a specificity of 92% (95% CI 72-99). The positive likelihood ratio was 12.5 (95% CI 3.3-47.2). Severe vascularization at CEUS and active vascular18F-FDG uptake were significantly more frequent in active disease according to Kerr's criteria compared to inactive (P = 0.001 and P = 0.002, respectively).
  
  
  
  Carotid CEUS vascularization grade and the grade of vascular inflammation on18F-FDG-PET were correlated in patients with LVV.
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Germanò
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Macchioni
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Possemato
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boiardi
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Nicolini
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Casali
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Annibale
authors.initials: A
authors.lastname: Versari
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pipitone
authors.affiliation: Azienda Ospedaliera IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
mesh_terms: D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*; D014657:Vasculitis / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18