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Venous vessel wall thickness in lower extremity is increased in male patients with Behcet's disease
Fatma Alibaz-Oner1, Rabia Ergelen2, Aydan Mutis3
1Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey. falibaz@gmail.com.
Insights
Increased common femoral vein thickness detected by Doppler ultrasound may indicate venous inflammation in Behcet
Area of Science:
- Vascular Medicine
- Rheumatology
- Diagnostic Imaging
Background:
- Vascular involvement is a significant cause of mortality in Behcet's disease (BD), particularly affecting young males.
- Early detection of venous abnormalities is crucial for managing Behcet's disease (BD).
Purpose of the Study:
- To investigate vessel wall thickness (VWT) and venous dilatation in male Behcet's disease (BD) patients using Doppler ultrasound.
- To assess the diagnostic potential of common femoral vein (CFV) thickness in identifying Behcet's disease (BD).
Main Methods:
- Doppler ultrasound (US) was used to measure bilateral common femoral vein (CFV) wall thickness and saphenous vein (SV) dilatation in 61 male BD patients, 37 healthy males (HC), and 27 male ankylosing spondylitis (AS) patients.
- Measurements were taken by a radiologist blinded to the case status.
- Receiver Operating Characteristic (ROC) curve analysis was performed to determine diagnostic cut-off values.
Main Results:
- Venous measurements, including CFV thickness, were significantly higher in Behcet's disease (BD) patients compared to ankylosing spondylitis (AS) and healthy controls (HC) (p < 0.001).
- Cut-off values for right and left CFV thickness for BD were 0.49 mm and 0.48 mm, respectively, demonstrating high sensitivity and specificity (e.g., right CFV: 81% sensitivity, 78.4% specificity).
- Increased CFV thickness was observed in Behcet's disease (BD) patients independently of other vascular involvement, suggesting it may be a specific sign of venous inflammation.
Conclusions:
- Increased common femoral vein (CFV) thickness, detectable by Doppler ultrasound (US), may serve as a specific indicator of venous inflammation in Behcet's disease (BD).
- Assessment of femoral vein thickness using US shows promise as a potential diagnostic tool for Behcet's disease (BD), especially in young males.
- Doppler ultrasound (US) evaluation of CFV thickness offers a non-invasive method for early detection and diagnosis in suspected Behcet's disease (BD) cases.
Abstract:
Vascular involvement, especially in young males, is seen in up to 40% of the patients with Behcet's disease (BD) and is a major cause of mortality and morbidity. In this study, we investigated vessel wall thickness (VWT) and dilatation in lower extremity veins with Doppler ultrasound (US) in male BD patients. Sixty-one male patients with BD, 37 healthy male controls (HC) and 27 male patients, with ankylosing spondylitis (AS), were included in the study. Venous Doppler US was performed by an experienced radiologist blinded to cases. Bilateral common femoral vein (CFV) wall thickness and great/small saphenous vein (SV) dilatations were assessed. All venous measurements were significantly higher in BD compared to AS and HC (p < 0.001 for all). Both right and left extremity CFV thicknesses had a high area under the ROC curve (> 0.8). Cut-off values for right and left CFV thicknesses for BD was 0.49 and 0.48 mm, respectively. High sensitivity and specificities are observed for both measurements (right CFV: sensitivity 81%, specificity 78.4%; left CFV: sensitivity 82.8%, specificity 81.1%). We found increased CFV thickness in BD patients independent of vascular involvement. As a similar change was not observed in controls, increased CFV thickness may be a specific sign of venous inflammation in BD. Our acceptable sensitivity and specificity values of CFV measurements suggest that assessment of femoral vein thickness with US may be a candidate diagnostic tool, especially in young males suspected of BD.