OBJECTIVE: To compare the diagnostic efficiency of the 1990 American College of Rheumatology (ACR) classification criteria for Takayasu arteritis (TA) and the 2022 ACR classification criteria for TA in Chinese populations. METHODS: The clinical and imaging data of TA patients and patients with arterial stenosis or occlusion caused by atherosclerosis who were admitted to Peking University Third Hospital from May 2012 to May 2022 were retrospectively analyzed. Clinical diagnosis of TA by two rheumatologists were defined as the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and the area under the receiver operating characteristics (ROC) curve (AUC) of the above two classification criteria were compared. In addition, this study also attempted to apply new imaging modalities, such as color Doppler ultrasound (CDUS), computed tomography angiography (CTA), magnetic resonance angiography (MRA) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in the 1990 ACR classification criteria to find whether this approach would improve the diagnostic efficiency. At the same time, the imaging features of the two groups were compared. RESULTS: The sensitivity (91.75%), positive predictive value (94.68%), negative predictive value (92.79%), accuracy (93.66%) and AUC (0.979) of the 2022 ACR TA classification criteria were better than those of the 1990 ACR TA classification criteria (45.36%, 91.67%, 66.24%, 72.20% and 0.855, respectively). In addition, we included new imaging modalities, such as CDUS, CTA, MRA and PET/CT in the 1990 ACR TA classification criteria, and the sensitivity, positive predictive value, negative predictive value, accuracy and AUC were significantly improved, which were 63.92%, 92.54%, 74.64%, 80.49% and 0.959, respectively, but still lower than those of the 2022 ACR classification criteria of TA (P < 0.001). The TA patients had more arterial stenosis (P=0.030), while the atherosclerosis patients had more arterial occlusion (P=0.021). There was no significant difference in arterial aneurysm or dissection (P=0.171). The TA patients had more involvement of ≥3 arteries (P=0.013), while the atherosclerosis patients had more unique artery involvement (P=0.011). CONCLUSION Compared with the 1990 ACR classification criteria for TA, the 2022 ACR classification criteria had higher diagnostic efficiency and might be more sui-table for the Chinese populations. Using more imaging modalities would improve the diagnostic perfor-mance of 1990 ACR classification criteria.
Humans ; Takayasu Arteritis/diagnostic imaging* ; Positron Emission Tomography Computed Tomography ; Retrospective Studies ; Constriction, Pathologic ; East Asian People ; Atherosclerosis

OBJECTIVETo explore changes in the carotid arteries in Tarkayasu arteritis (TA) with computed tomographic angiography (CTA).

METHODSThe common carotid artery intima-medial thickness (CCA-IMT) in 20 common carotid arteries (CCAs) in 10 controls and 40 CCAs in 20 patients with TA were analyzed and compared.

RESULTSContrast-enhanced CT scanning combined with the application of 3D reconstruction clearly showed the carotid vascular luminal abnormalities, such as stenosis, occlusion, dilation, and aneurysm formation. CCA-IMT increased in all the patients with TA affecting carotid arteries. CCA-IMT was significantly larger in the patients than in controls [(0.36 +/- 0.13) cm vs. (0.03 +/- 0.02) cm, P < 0.05] , and was significantly larger in patients with active diseases than in those without active diseases [(0.44 +/- 0.09) cm vs. (0.24 +/- 0.10) cm, P < 0.05].

CONCLUSIONCCA-IMT increases in TA affecting carotid arteries, especially in active diseases.

Adolescent ; Adult ; Carotid Arteries ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Takayasu Arteritis ; diagnostic imaging ; Tomography, Spiral Computed ; methods

With the advancement of multi-detector spiral computer tomography (MSCT) and Z-axis resolution, CT has progressively been applied in showing the anatomy and disease of vessels; therefore, CTA is increasingly important to the diagnosis of vascular diseases. In this paper we focuses on a review of the progress of MSCT and CTA in diagnosing aortic diseases.
Aneurysm, Dissecting ; diagnostic imaging ; Aortic Aneurysm ; diagnostic imaging ; Aortic Diseases ; diagnostic imaging ; Humans ; Takayasu Arteritis ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo compare the diagnostic value of (99)Tc(m)-MAA pulmonary perfusion imaging with that of pulmonary angiography for pulmonary involvement in Takayasu's arteritis.

METHODSTwenty-one patients (19 women, 2 men), with diagnosed Takayasu's arteritis and underwent both (99)Tc(m)-MAA pulmonary perfusion imaging and pulmonary angiography, were retrospectively analyzed.

RESULTSOut of the 21 patients, pulmonary angiography detected 11 patients with pulmonary artery involvement whereas 13 patients were revealed perfusion defects by pulmonary perfusion imaging. The agreement of diagnosis by pulmonary perfusion imaging with that by pulmonary angiography existed in 19 patients (90.5%, Kappa = 0.81, P < 0.0001). There were 331 pulmonary segments consistently diagnosed by pulmonary perfusion imaging and pulmonary angiography in 378 pulmonary segments (87.5%, Kappa = 0.74, P < 0.0001).

CONCLUSIONSPulmonary perfusion imaging is highly accorded with pulmonary angiography in detecting the pulmonary involvement in Takayasu's arteritis. Therefore, pulmonary perfusion imaging could be used as a non-invasive screening test for the pulmonary artery involvement in Takayasu's arteritis.

Adolescent ; Adult ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Pulmonary Artery ; diagnostic imaging ; Radiography ; Radionuclide Angiography ; Retrospective Studies ; Takayasu Arteritis ; diagnostic imaging ; Technetium Tc 99m Aggregated Albumin ; Young Adult