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Carotid sonographic features in Takayasu's arteritis: A case-control study.

Maryam Haghighi-Morad1, Reza Rezaei2, Muhanna Kazempour3

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Takayasu arteritis (TAK) involves large arteries and shows distinct carotid ultrasound findings like the macaroni sign and increased intima-media thickness (IMT). These changes correlate with inflammatory markers such as C-reactive protein (CRP).

Keywords:
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Area of Science:

  • Vascular Medicine
  • Rheumatology
  • Diagnostic Imaging

Background:

  • Takayasu arteritis (TAK) is a rare large-vessel vasculitis primarily affecting the aorta and its branches.
  • Ultrasonography can detect increased intima-media thickness (IMT) and atherosclerotic changes in the carotid arteries of TAK patients.
  • Distinguishing TAK from other conditions with similar vascular manifestations is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To evaluate detailed carotid sonographic features in patients with Takayasu arteritis (TAK).
  • To compare these sonographic findings with those in patients with diabetes mellitus (DM).
  • To assess the correlation between carotid sonographic parameters and inflammatory markers in TAK.

Main Methods:

  • A case-control study involving 15 TAK patients and 15 DM patients.
  • Evaluation included cardiovascular risk factors, carotid ultrasonography, and serum inflammatory markers (ESR, CRP).
  • Data were analyzed using univariate and multiple regression tests.

Main Results:

  • Atherosclerotic plaques were observed in 46.7% of TAK and 53.3% of DM patients.
  • TAK patients exhibited significantly higher IMT in the common (CCA) and internal carotid arteries (ICA).
  • Characteristic findings in TAK included the macaroni sign, turbulent flow, and higher CCA resistivity index (RI); IMT correlated with CRP levels.

Conclusions:

  • Carotid ultrasonography is a valuable diagnostic tool for Takayasu arteritis (TAK).
  • Key distinguishing sonographic features of TAK include the macaroni sign, turbulent flow, and elevated IMT and RI.
  • Increased carotid IMT in TAK is associated with elevated C-reactive protein (CRP) levels.