Takayasu arteritis: assessment of coronary arterial abnormalities with 128-section dual-source CT angiography of the coronary arteries and aorta

Eun-Ju Kang, Sung Mok Kim, Yeon Hyeon Choe, Ga Yeon Lee, Ki-Nam Lee, Duk-Kyung Kim
Radiology 2014, 270 (1): 74-81

PURPOSE: To evaluate coronary arterial lesions and to assess their correlation with clinical findings in patients with Takayasu arteritis (TA) by using coronary computed tomographic (CT) angiography.

MATERIALS AND METHODS: This retrospective study was approved by the hospital internal review board, and informed consent was waived. A total of 111 consecutive patients with TA (97 female, 14 male; mean age, 44 years ± 13.8 [standard deviation]; age range, 14-74 years) underwent CT angiography of the coronary arteries and aorta with 128-section dual-source CT. CT angiographic, clinical, and laboratory findings of each patient were retrospectively reviewed. Statistical differences between coronary CT angiographic findings and clinical parameters were examined with univariate analysis.

RESULTS: Of 111 patients, 32 (28.8%) had cardiac symptoms and the remaining 79 (71.2%) had no cardiac symptoms. Fifty-nine patients (53.2%) had coronary arterial lesions at coronary CT angiography. Three main radiologic features were detected: coronary ostial stenosis (n = 31, 28.0%), nonostial coronary arterial stenosis (n = 41, 36.9%), and coronary aneurysm (n = 9, 8.1%). Coronary artery ostial or luminal stenosis of 50% or more or coronary aneurysms were observed in 26 (23.4%) patients with TA. Patients with coronary arterial abnormalities at coronary CT angiography had higher incidences of hypertension (P = .02), were older at the time of CT (P = .01), and had longer duration of TA (P = .02) than those without coronary artery abnormalities. The presence of cardiac symptoms, disease activity, and other comorbidities was not associated with differences in coronary artery involvement.

CONCLUSION: In patients with TA, there is a high prevalence of coronary arterial abnormalities at coronary CT angiography, regardless of disease activity or symptoms. Thus, coronary CT angiography may add information on coronary artery lesions in patients with TA.

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