Debanjali Sinha1, Sumantro Mondal, Arijit Nag, Alakendu Ghosh. 1. Department of Rheumatology, Institute of Post-Graduate Medical Education and Research (IPGME&R), 244A, AJC Bose Road, Kolkata 700020, India. alakendughosh@gmail.com.
Abstract
OBJECTIVES: The objectives of this study were to develop a scoring system with colour Doppler ultrasound (CDUS) in patients with Takayasu's arteritis, to correlate the CDUS score with the Indian Takayasu's Activity Score (ITAS) and to assess the degree of agreement between CDUS and angiogram in the diagnosis of Takayasu's arteritis. METHODS: Nineteen angiographically confirmed Takayasu's arteritis patients fulfilling three or more of the 1990 ACR criteria were evaluated. Their ITASs were recorded. A CDUS scoring system, CDUS-Kolkata (CDUS-K), was devised based on the presence of stenosis and altered flow patterns. It was then correlated with the ITAS. An inter-rater agreement analysis was done between the CDUS-K scores and angiographic scores in selected arterial sites. RESULTS: We found a significant degree of correlation between the ITAS and the CDUS-K score (r = 0.7144, 95% CI 0.3852, 0.8823, P = 0.0006). A high degree of correlation was found between the CDUS-K and angiographic scores in the selected arterial sites (κ-value = 0.725 on inter-rater agreement analysis). CONCLUSION: CDUS imaging may be used as an objective tool for assessing disease severity in Takayasu's arteritis. Development of a CDUS-K scoring system would be a supplementary tool to clinical scoring and the ITAS. CDUS imaging could be a cost-effective, non-invasive and reliable substitute for angiogram, especially for follow-up in Takayasu's arteritis patients.
OBJECTIVES: The objectives of this study were to develop a scoring system with colour Doppler ultrasound (CDUS) in patients with Takayasu's arteritis, to correlate the CDUS score with the Indian Takayasu's Activity Score (ITAS) and to assess the degree of agreement between CDUS and angiogram in the diagnosis of Takayasu's arteritis. METHODS: Nineteen angiographically confirmed Takayasu's arteritispatients fulfilling three or more of the 1990 ACR criteria were evaluated. Their ITASs were recorded. A CDUS scoring system, CDUS-Kolkata (CDUS-K), was devised based on the presence of stenosis and altered flow patterns. It was then correlated with the ITAS. An inter-rater agreement analysis was done between the CDUS-K scores and angiographic scores in selected arterial sites. RESULTS: We found a significant degree of correlation between the ITAS and the CDUS-K score (r = 0.7144, 95% CI 0.3852, 0.8823, P = 0.0006). A high degree of correlation was found between the CDUS-K and angiographic scores in the selected arterial sites (κ-value = 0.725 on inter-rater agreement analysis). CONCLUSION:CDUS imaging may be used as an objective tool for assessing disease severity in Takayasu's arteritis. Development of a CDUS-K scoring system would be a supplementary tool to clinical scoring and the ITAS. CDUS imaging could be a cost-effective, non-invasive and reliable substitute for angiogram, especially for follow-up in Takayasu's arteritispatients.
Authors: Antoine G Sreih; Fatma Alibaz-Oner; Tanaz A Kermani; Sibel Z Aydin; Peter F Cronholm; Trocon Davis; Ebony Easley; Ahmet Gul; Alfred Mahr; Carol A McAlear; Nataliya Milman; Joanna C Robson; Gunnar Tomasson; Haner Direskeneli; Peter A Merkel Journal: J Rheumatol Date: 2017-09-01 Impact factor: 4.666