Behçet disease: pulmonary arterial involvement in 15 cases

Area of Science:

• Vascular Medicine
• Radiology
• Rheumatology

Background:

• Behçet disease (BD) is a multisystem inflammatory disorder.
• Pulmonary arterial involvement, including aneurysms, is a rare but severe complication of BD.
• Early diagnosis and characterization of pulmonary manifestations are crucial for patient management.

Purpose of the Study:

• To detail the radiologic findings of pulmonary arterial involvement in patients with Behçet disease.
• To evaluate the diagnostic utility of various imaging modalities for pulmonary aneurysms in BD.
• To correlate imaging findings with clinical outcomes and prognosis.

Main Methods:

• Retrospective analysis of 15 male patients with known Behçet disease and diagnosed pulmonary arterial aneurysms between 1978 and 1993.
• Imaging techniques included chest radiography, computed tomography (CT), angiography, and magnetic resonance (MR) imaging.
• Correlation of imaging findings with clinical course and patient outcomes.

Main Results:

• Thirty-one pulmonary arterial aneurysms were identified in 15 patients.
• Multiple aneurysms were more common (12 patients) than single aneurysms (3 patients).
• Pulmonary artery occlusion was present in six patients; fatal rupture occurred in five, while two showed aneurysm regression.

Conclusions:

• Intravenous digital subtraction angiography is the preferred method for documenting pulmonary arterial involvement in BD.
• MR imaging aids in the presumptive diagnosis of occluded aneurysms.
• Pulmonary aneurysms in Behçet disease indicate a poor prognosis, but spontaneous regression and non-rupture are possible.