Abstract 1834: Successful Real Time Evaluation of Intramural Inflammation of Carotid Artery with 2D Elasticity Image by High-Resolution Doppler Technique in Patients with Takayasu Arteritis
Intramural inflammation has been suggested to play an important role in the pathogenesis of various vascular diseases, including atherosclerosis. We have developed a novel high-resolution Doppler technique “Phase Tracking Method (PTM)”, which is unique for its higher spatial and temporal resolution (Rf: 9kHz, resolution ≥0.5μm/sec) as well as its ability to correlate with histological components as detailed in Circulation 2003 and IEEE uffc 2004. In this study, we examined the usefulness of PTM to evaluate intramural inflammation in Takayasu arteritis (TA).
Method: Forty patients with TA were examined for 2D, 4cm longitudinal image of the elasticity distribution across the carotid artery by PTM (intramural sampling region; 0.37mm x 0.5mm).
The intramural elasticity ranged from 7 to 125kPa in normal subjects, showing a smooth single-peak (peak: 41±9kPa) configuration in histogram.
In patients with active TA, the intramural elasticity became much smaller, ranging from 1 to 26kPa, with a sharp peak at 7±5kPa in histogram. 2D image was characterized by diffusely distributed compliant (possibly edematous) material. After the effective steroid hormone therapy, such diffuse, compliant material rapidly disappeared and reverted to a much elastic cross-sectional image, as seen in normal subjects (figure⇓).
Parameters from elasticity distribution were superior to serological markers (CRP or SAA) and intima-media thickness.
Sensitivity and specificity of PTM for evaluating the intramural inflammation were 100 and 95%, respectively.
Conclusion: PTM is quite useful to precisely describe the cross-sectional image of the intramural arterial inflammation in TA.