Value of conventional carotid artery sonography combined with contrast-enhanced ultrasound in evaluating the activity of Takayasu arteritis
Objective To perform semi-quantitative grading of carotid artery wall enhancement in patients with Takayasu arteritis(TA)using contrast-enhanced ultrasound(CEUS),and to investigate the value of conventional carotid artery sonography combined with CEUS in evaluating the activity of TA.Methods A total of 59 patients with TA were en-rolled according to the American College of Rheumatology classification criteria,the clinical active and inactive stages were determined based on the National Institution of Health(NIH)score.The patients were divided into three groups ac-cording to the grade of enhancement on CEUS.The correlation of CEUS grade and conventional ultrasound parameters with clinical activity parameters of the disease was analyzed,as well as their value in predicting the clinical activity of the dis-ease.Results The CEUS enhancement grade,wall thickness,and outer diameter of the carotid artery were positively cor-related with NIH score,erythrocyte sedimentation rate,and C-reactive protein,among which CEUS enhancement grade showed the highest degree of correlation(r=0.438,0.560,and 0.471,P<0.01).CEUS grade≥2 and CEUS grade 3 had an area under the ROC curve(AUC)of 0.782 and 0.725,respectively,in predicting the clinical activity of the disease(P<0.001),with a sensitivity of 77%and 53%,respectively,and a specificity of 80%and 92%,respectively.Carotid ar-tery wall thickness≥1.95 mm combined with CEUS grade≥2 had an AUC of 0.804 in predicting the clinical activity of the disease(P<0.001),with a sensitivity of 80%and a specificity of 81%,showing a better predictive efficacy than carotid artery wall thickness alone(Z=2.535,P=0.011).Conclusion CEUS enhancement grade and wall thickness of the ca-rotid artery are significantly correlated with the clinical activity of TA,and carotid artery wall thickness combined with CEUS enhancement grade can effectively evaluate the clinical activity of TA.