| Background Takayasu's arteritis(TA)is a chronic, progressive, granulomatous arteritis. The process of inflammatory could lead to arterial wall thickness, stenosis, occlusion, dilatation or aneurysm formation. TA is mostly found in young female, and the lesion usually occurs in aorta and its main branches, pulmonary artery and coronary artery. Prior to the pulselessness period, the clinical manifestation such as fever, palpitation, courbature and fatigue is lack of specificity. Monthes and years later, the symptom or sign will appear due to the stenosis of involved arteries, such as intermittent claudication, peripheral pulses weakening or vanish, and vascular murmur.So far, the involvement of Takayasu's arteritis cannot be comprehensively reflected by diagnosis and classification criteria. And each imaging examination has its advantage and disadvantage. Therefore, it will be of great value for clinical application in search of a convenient, rapid, comprehensive examination for detecting lesion extent of Takayasu's arteritis. In this study, a single low-dose whole-body CT angiography(CTA)scan is applied for TA patients by dual-source CT(DSCT) since it has been widely applicated with its ultra-fast scan speed and low radiation dose. The assessment of radiation dose and the quality of images, as well as the comprehensive examination of involved arteries, especially peripheral arteries, will provide significant anatomic information and for the clinical diagnosis and treatment of TA. No previous studies have reported a whole-body CTA by using DSCT in TA patients. Objective This study aimed to investigate whether a whole-body CTA is feasible in TA patients and whether the incremental information of peripheral arteries benefits clinical diagnosis and treatment. Methods A whole-body CTA was performed in 97 consecutive patients with suspected TA. The scanning protocol was performed with a tube voltage of 80 kV and a referenced tube current of 300 mAs. The volume CT Dose Index(CTDIvol)and dose-length product(DLP)were recorded for all scans. Subjective image quality of different arteries in seven anatomic locations were assessed, including intracranial, and cervical arteries, thoracic, and abdominal aorta, as well as extremity arteries. Objective image quality was assessed in middle cerebral artery, common carotid artery, aortic arch, brachial artery, thoracic aorta, abdominal aorta, arteria iliac communis, femoral artery, popliteal artery and posterior tibial artery. In addition, CT findings of whole-body arteries were recorded. Results Out of the 97 patients, 80 with definite diagnosis of TA were enrolled in this present analysis. Mean CTDIvol and DLP for all patients were 2.5±0.8 mGy and 402.3±90.3mGy?cm, respectively. The scores of subjective image quality were all >1.5. The diagnostic accuracy was 100% for neck, chest, abdomen, and thigh, 95% for upper extremity, 65% for head, and 61% for shank, respectively. The scoring order of objective image quality(CNR and SNR) was the arteria iliac communis, common carotid artery, femoral artery, popliteal artery, aortic arch, thoracic aorta, brachial artery, abdominal aorta, middle cerebral artery and posterior tibial artery. A total of 111(14.7%) involved peripheral arteries, including 5.7% of the intracranial arteries, 5.4% of upper extremity arteries and 3.6% of lower extremity arteries were extra detected. CT findings of TA included lumen changes and arterial wall changes. Changes of lumen included stenosis, occlusion, dilation/aneurysm, and stenosis combined with dilation. Changes of arterial wall included thickness and calcification. Additionally, 56.3% of TA patients were detected with complicated thoracic lesions, including subpleural effusion, subpleural microvascular dilation, intercostal soft tissue swolling and intercostal artery dilation. Conclusion A whole-body CTA by DSCT is feasible in TA patients, with acceptable radiation dose and diagnostic image quality. The incremental CT findings of intracranial, lower extremity and upper extremity arteries provides valuable information of whole-body arteries involvement, which may helpful to clinical comprehensive diagnosis and treatment. |
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