Use of contrast-enhanced computed tomographic imaging to diagnose and evaluate Behçet's disease with vascular
Lin Qi1, Jianfei Cai2, Dingbiao Mao1
1Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, P.R. China.
Insights
Multi-slice CT scans reveal characteristic imaging features of vascular aneurysms in Behçet's disease (BD). These CT findings aid in diagnosing vascular complications of BD, even without typical symptoms.
Area of Science:
- Vascular Medicine
- Radiology
- Rheumatology
Background:
- Behçet's disease (BD) is a multisystem inflammatory disorder.
- Vascular involvement is a serious complication of BD, affecting both arteries and veins.
- Early diagnosis and characterization of vascular complications are crucial for patient management.
Purpose of the Study:
- To evaluate multi-slice CT findings in patients with Behçet's disease and vascular complications.
- To identify characteristic CT imaging features of vascular aneurysms in BD.
- To correlate imaging findings with clinical and laboratory parameters.
Main Methods:
- Retrospective analysis of multi-slice CT scans from 45 patients with BD and vascular involvement.
- Detailed analysis of aneurysm characteristics including diameter, length, wall thickness, and enhancement patterns.
- Comparison of aneurysms in the aorta versus larger arteries.
Main Results:
- 42 aneurysms were identified, with most showing homogeneous enhancement on contrast-enhanced CT.
- Aortic aneurysms were more likely to have mural thrombus, thicker walls, unclear borders, RP type, and longer extension compared to other arterial aneurysms.
- Unclear aneurysmal wall borders on CT correlated with elevated erythrocyte sedimentation rate.
Conclusions:
- Characteristic CT imaging features can help diagnose vascular involvement in Behçet's disease.
- CT findings can assist in assessing the severity of vascular complications.
- Imaging features are particularly valuable when classical clinical manifestations are absent.
Abstract:
In the present study, multi-slice CT results of patients with Behçet's disease (BD) and vascular complications were retrospectively evaluated. From January 2016 to May 2018, 45 of 361 patients with BD were diagnosed with vascular involvement. The clinical background, laboratory parameters and response to therapy of those patients were assessed. The following characteristics of vascular aneurysms were analyzed: Maximum diameter, length, wall thickness, borders, luminal changes, mural thrombus, cystic change of the vessel walls, asymmetric bulging of the right part of the aortic wall (RP type) and calcific plaques. The 45 BD patients analyzed included 37 males and 8 females with a median age of 40 years (30-49 years). Significant differences were observed among genders regarding age, ocular disorders and digestive-tract ulceration. A total of 42 aneurysms were identified with a mean diameter of 43 mm. Most aneurysmal walls (88%) were homogeneously enhanced on contrast-enhanced CT. Comparison of groups classified by aortic and larger arterial aneurysms indicated that aneurysms occurring in the aorta were more likely to form a mural thrombus, have a thicker wall (P<0.001) and unclear borders (P=0.036), to be of the RP type (P=0.003) and have a longer extension (P=0.001) compared with those in larger arteries. Unclear border of the aneurysmal wall was the only radiologic predictor correlated with an elevated erythrocyte sedimentation rate (P<0.001). In conclusion, characteristic CT imaging features of aneurysms may help to diagnose vascular involvement of BD and assess its severity, particularly in the absence of the classical clinical manifestations.
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