Ultrasonographic measurement of the vascular wall thickness and intima-media thickness in patients with Behçet’s disease with symptoms or signs of vascular involvement: A cross-sectional study

Abstract

Objectives This study aims to measure and compare bilateral carotid intima-media thickness (CIMT), bilateral jugular, common femoral, and main portal vein wall thicknesses (VWTs) in Behçet’s disease (BD) patients with and without vascular involvement to obtain a cut-off value for vascular complications and determine their relationship with disease activity. Patients and methods Sixty-three BD patients (41 males, 22 females; median age: 38.0 years; min 20 - max 71 years) and 30 healthy control subjects (14 males, 16 females; median age: 40.3 years; min 21 - max 60 years) were included in this cross-sectional study between February and March 2020. According to imaging findings, BD patients were divided into two groups as those with and without vascular complications. Disease duration, medical treatment and BD manifestations of patients were questioned. Disease activity was evaluated using the Behçet's Disease Current Activity Form (BDCAF) and the Behçet's Syndrome Activity Scale (BSAS). Two radiologists blinded to the diagnosis of BD used ultrasound to measure VWT and CIMT. Receiver operating characteristics were assessed to obtain sensitivity and specificity values for each VWT and CIMT. Results The groups were similar in terms of age, sex, and body mass index (p>0.05). There was a significant difference between the BD groups when the BDCAF and BSAS scores were compared, while there was no difference between them in terms of disease duration and medical treatment (p>0.05). All VWTs and CIMTs were significantly higher in patients with BD compared to healthy controls (p<0.05). There was no significant difference between the BD groups in terms of CIMT, jugular and common femoral VWTs (p>0.05). But portal VWT was significantly higher in patients with vascular involvement (p<0.05). A cut-off value of ≥1.35 mm yielded a sensitivity of 79.2% and a specificity of 82.4% for the diagnosis of vascular involvement with the highest Youden's index (area under the curve, 0.869; 95% confidence interval, 0.783 to 0.956). Conclusion Portal VWT has high sensitivity and specificity for the screening of vascular involvement in patients with BD.

Measuring the Whole Wall Thickness of the Common Femoral Vein as a Distinctive Diagnostic Tool to Distinguish Behçet’s Disease Presenting with Oral Ulcers from Recurrent Aphthous Stomatitis

“…Similar to other studies in which the VWT was measured in BD ( Supplementary Table S1 ), we found that the VWT of the CFV was significantly higher in the BD group than in the other study groups. While the WWT of the mean right CFV of BD patients in the present study was 0.68 ± 0.12 mm, it was found to be between 0.68–0.92 mm in other studies [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. In the present study, the WWT of the CFV had an advantage in 79.8% sensitivity and 64.7% specificity at a cutoff value of 0.58 mm.…”

“…The first controlled Doppler US study by Alibaz-Oner et al showed that vein wall thickness (VWT) increased in the lower extremity veins of male patients with BD, which was independent of vascular involvement [12]. Furthermore, other US studies involving different disease groups supported that the VWT increased in cases of BD [11,[13][14][15][16][17]. Based on these findings, it has been suggested that the measurement of the common femoral vein (CFV) thickness can be a valuable, practical, and cost-effective diagnostic tool for diagnosing BD [9].…”

Vascular Involvement in Behcet’s Disease: An Evaluation of 147 Cases and Literature Review

“…Behçet’s disease sets itself apart from other vasculitides with an increased vein wall thickness, as evidenced by Doppler ultrasonography studies. [ 6 , 7 ] The co-occurrence of various arterial and venous events within the same patient, referred to as a vascular cluster, is a recognized phenomenon. The occurrence of venous thrombus in the majority of patients with either vascular cluster or pulmonary involvement suggests that there could be a common etiology of vascular events (thrombus, stenosis, aneurysm).…”

Behçet's syndrome: one year in review 2022

“…Clinical significance is unclear since no diseased controls were included and the data is based on diagnosis codes, carrying the risk of misdiagnosis. Growing evidence indicates that venous wall thickness (VWT) of the lower extremity veins is increased in BS compared to that found in several inflammatory diseases and healthy controls (66)(67)(68)(69)(70)(71). VWT was especially increased among those BS patients with no apparent vascular involvement suggesting that VWT could be an early indication of vascular inflammation (66,71).…”