Visualization of arterial wall vascularization using superb microvascular imaging in active-stage Takayasu arteritis

Sato, Wakana; Sato, Takeya; Iino, Takako; Seki, K; Watanabe, Hiroyuki

doi:10.1093/ehjci/jey285

Cited by 10 publications

(9 citation statements)

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“…Besides being involved in inflammation, PTX3 has also been evidenced to play critical regulatory roles in endothelial and smooth muscle cell function, which dominates the mechanism of vascular remodeling in TAK patients. Angiogenesis occurs in the arterial wall in active TAK [21] and has been evidenced by proliferated endothelial cells [22], which aids the development of collateral circulation of the arterial wall. PTX3 inhibits angiogenesis [23] by binding and neutralizing the fibroblast growth factor 2 (FGF2).…”

Section: Plos Onementioning

confidence: 99%

Pentraxin 3 is more accurate than C-reactive protein for Takayasu arteritis activity assessment: A systematic review and meta-analysis

Wen

Hou

et al. 2021

PLoS ONE

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Aims Whether the circulating levels of pentraxin 3 (PTX3), an acute phase reactant (APR), are higher in active Takayasu arteritis (TAK), and if so, whether PTX3 is more accurate than C-reactive protein (CRP) in TAK activity assessment has been investigated in this study. Study design Research works such as PubMed, Embase, ScienceDirect, Cochrane Library, and two Chinese literature databases (CNKI and WanFang) were searched for studies conducted till August 30th, 2019. Two investigators searched the studies independently, who evaluated the quality of the study using the Newcastle–Ottawa scale (NOS) and extracted data. Pooled standard mean difference (SMD) and diagnostic indexes, with a 95% confidence interval (CI), were calculated using a random-effect model. Results Totally, 8 studies involving 473 TAK (208 active and 265 inactive TAK) patients and 252 healthy controls were eventually included in the meta-analysis. PTX3 level in the blood in active TAK patients were found to be higher than that in dormant TAK with pooled SMD of 0.761 (95% CI = 0.38–1.14, p<0.0001; I2 = 68%, p of Q test = 0.003). And there was no publication bias. Among the 8 studies, 5 studies identified active TAK with both PTX3 and CRP. The pooled sensitivity, specificity, and AUC values of PTX3 in active TAK diagnosis were higher than those of CRP (0.78 [95% CI = 0.65–0.87] vs. 0.66 [95% CI = 0.53–0.77], p = 0.012; 0.85 [95% CI = 0.77–0.90] vs. 0.77 [95% CI = 0.56–0.90], p = 0.033; 0.88 [95% CI = 0.85–0.90] vs. 0.75 [95% CI = 0.71–0.79], p < 0.0001). It showed potential publication bias using Egger’s test (p of PTX3 = 0.031 and p of CRP = 0.047). Conclusions PTX3 might be better than CRP in the assessment of TAK activity. Yet, it should be cautious before clinical use for moderate heterogeneity and potential publication bias of the meta-analysis.

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Section: Plos Onementioning

confidence: 99%

Pentraxin 3 is more accurate than C-reactive protein for Takayasu arteritis activity assessment: A systematic review and meta-analysis

Wen

Hou

et al. 2021

PLoS ONE

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“…Additional vascular studies of SMI focused on endo‐leaks after aortic grafting, visualization of hepatic artery after liver transplant, cardiac imaging in fetuses, and assessment of intracranial vasculature in neonatal transcranial ultrasonography 18‐21 . A single case report also demonstrated possible utility of SMI in characterization of wall inflammation in Takayasu arteritis 22 . There is also a single case demonstrating the corkscrew collaterals in Buerger's disease using SMI 23 .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of superb microvascular imaging in depiction of corkscrew collaterals in Buerger's disease

Nas

Kandemirli

Gursel

et al. 2020

J of Clinical Ultrasound

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PurposeTo evaluate the corkscrew collaterals in Buerger's disease by superb microvascular imaging (SMI) and power Doppler ultrasonography (PDU).MethodsWe evaluated with SMI and PDU 14 patients with Buerger's disease in whom corkscrew collaterals had been identified on digital subtraction angiography (DSA). Corkscrew collaterals were classified on DSA and PDU based on their size and morphology.ResultsA total of 17 vascular regions of collateral vessel formation were assessed. Based on DSA classification, there were three cases of type I collaterals (arterial diameter of >2 mm with large helical pattern), seven cases of type III collaterals (arterial diameter of 1‐1.5 mm with small helical pattern), and seven cases of type IV collaterals (arterial diameter of <1 mm with tiny helical pattern). On PDU, all type I collaterals on DSA appeared as “large snake” images, all type III collaterals on DSA appeared as “small snake” images, and all type IV collaterals on DSA appeared as dots. SMI imaging, both in color and monochrome mode, provided superior demonstration of the continuity of the vessel of large or small “snake” images. In cases appearing as dot pattern on PDU, color SMI was able to show continuity of the flow signal as a helical pattern.DiscussionSMI is a promising new Doppler imaging technique that is superior to conventional power Doppler imaging in depiction and identification of corkscrew collaterals in Buerger's disease.

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“…Superb microvascular imaging (SMI) is a novel ultrasound imaging technology that can extract blood flow signals from large to small vessels without echo contrast media to indicate low velocity and microvascular flow [93]. Microvessels growing into the media layer represents the vascularization of the arterial wall, which is a sign of active phase [94]. Some studies suggested that the SMI signal might be a potential marker of vascular inflammation [93,94].…”

Section: Contrast-enhanced Ultrasonography and Superb Microvascular Imagingmentioning

confidence: 99%

“…Microvessels growing into the media layer represents the vascularization of the arterial wall, which is a sign of active phase [94]. Some studies suggested that the SMI signal might be a potential marker of vascular inflammation [93,94].…”

Section: Contrast-enhanced Ultrasonography and Superb Microvascular Imagingmentioning

confidence: 99%

Application progress of multiple imaging modalities in Takayasu arteritis

Jia

Liu

et al. 2021

Int J Cardiovasc Imaging

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Takayasu arteritis (TA) is a chronic, idiopathic, granulomatous large vessel vasculitis of unknown etiology. The clinical manifestations of TA are incredibly variable, mainly depending on the location of the lesions. In the light of its insidious progress and the diversity of clinical manifestations, a substantial proportion of patients might experience a considerable delay in diagnosis, which leads to irreversible malignant complications, highlighting the importance of early diagnosis. There has been accumulating evidence that early identification of disease is pivotal to initiate timely therapy and ameliorate the prognosis. Therefore, this review discusses and summarizes the latest evidence on the application progress of multiple imaging modalities.

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Visualization of arterial wall vascularization using superb microvascular imaging in active-stage Takayasu arteritis

Cited by 10 publications

References 0 publications

Pentraxin 3 is more accurate than C-reactive protein for Takayasu arteritis activity assessment: A systematic review and meta-analysis

Pentraxin 3 is more accurate than C-reactive protein for Takayasu arteritis activity assessment: A systematic review and meta-analysis

Diagnostic utility of superb microvascular imaging in depiction of corkscrew collaterals in Buerger's disease

Application progress of multiple imaging modalities in Takayasu arteritis

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