Sonographic Characterization of Arterial Dissections in Takayasu Arteritis.
OBJECTIVE
Takayasu arteritis is a relatively rare chronic nonspecific form of large-vessel vasculitis in which the involved vessels develop stenoses, occlusions, dilatations or aneurysms, and dissections. Dissections of the arteries in patients with Takayasu arteritis are not well understood. In this study, we explored the sonographic characterization of these rare complications secondary to Takayasu arteritis.


METHODS
We evaluated arterial dissections in 72 patients with a clinical diagnosis of Takayasu arteritis by vascular sonography and transthoracic echocardiography. We analyzed the dissection distribution and morphologic characteristics of the dissected intima/layer and lumen of the involved vessels.


RESULTS
Twelve of 72 patients had arterial dissections, in whom 16 dissected segments were identified. The involved arteries included the carotid, subclavian, vertebral, brachial, celiac, and femoral arteries, aortic arch, and abdominal aorta. The dissection lesions occurred at any age and coexisted with the aforementioned injuries. Evaluation of the dissected intima/layer and the involved lumen by sonography was technically complicated. The morphologic characteristics of the dissected intimae and involved lumens were complex, with most of the dissected intimae/layers having the characteristic "macaroni" sign in the arterial wall. High-frequency and high-resolution sonography, color Doppler flow imaging, and other techniques were useful in elucidating greater lesion details.


CONCLUSIONS
Arterial dissections in Takayasu arteritis can involve any anatomic vessel location and have complex morphologic characteristics. Sonography is the optimal technique for diagnosis and follow-up of patients with Takayasu arteritis and dissections.
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, ChinaDepartment of Radiology, University of North Carolina Hospital, Chapel Hill, North Carolina USADepartment of Medical Ultrasonography, Peking University International Hospital, Beijing, China tjw7169@126.com.
Jiong
J
Wang
Department of Radiology, University of North Carolina Hospital, Chapel Hill, North Carolina USA.
Yueh Z
YZ
Lee
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
Yi
Y
Cheng
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
Ye
Y
Zheng
Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Junyi
J
Gao
Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
Xiaobin
X
Tang
Department of Rheumatology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
Tian
T
Wang
Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
Chun
C
Zhang
D000328:Adult; D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography / Q000379:methods*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult
Takayasu arteritis; arterial dissection; sonography; transthoracic echocardiography; vascular ultrasound