Ultrasound morphological changes in the carotid wall of Takayasu's arteritis: monitor of disease progression.

BACKGROUND: The aims of this study were to examine ultrasound morphological changes in the carotid wall in cases of Takayasu's arteritis and to thereby determine the value of ultrasound for assessments of Takayasu's arteritis disease activity and follow-up studies.

METHODS: We used high-frequency ultrasound to analyze morphological changes in 51 Takayasu's arteritis patients and compared the findings with clinical and laboratory parameters. A follow-up study of 20 patients was performed.

RESULTS: Five types of ultrasonographic images were observed in the carotid walls of Takayasu's arteritis patients. Type III and type IV images were observed in younger patients; smaller wall thicknesses and less luminal stenosis were observed in these images. Type II and type IV images were more frequently obtained in cases involving active patients, whereas type I and type III images were more often acquired in cases involving inactive patients with significantly lower Indian Takayasu clinical activity scores. During follow-up, the wall thickness and outer diameter of the carotid increased in patients who relapsed and decreased in patients who remained in remission.

CONCLUSIONS: The five types of carotid ultrasound images reveal Takayasu's arteritis-related morphological changes in the vessel wall, which reflect anatomical changes. Carotid ultrasound should play a central role in monitoring the progression of Takayasu's arteritis.