Aortic involvement in recent-onset giant cell (temporal) arteritis: A case-control prospective study using helical aortic computed tomodensitometric scan
Aortic involvement in recent-onset giant cell (temporal) arteritis: A case-control prospective study using helical aortic computed tomodensitometric scan
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DOI：
10.1002/art.23577
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发表时间：
2008-05-15
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影响因子：
--
通讯作者：
Hamidou, Mohamed-A.
中科院分区：
文献类型：
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作者：
Agard, Christian;Barrier, Jacques-H.;Hamidou, Mohamed-A.
Objective.巨细胞动脉炎（GCA）累及大血管的患病率为3- 13%。主动脉炎是GCA最严重的并发症。计算机断层光密度（CT）扫描可以分析主动脉壁和主动脉腔内部分。因此，我们进行了一项研究，使用CT扫描，以分析主动脉异常的患者最近发生的GCA。这项前瞻性对照研究比较了活检证实的GCA患者与基于性别、年龄和心血管危险因素的匹配对照组。在GCA诊断后的4周内，患者接受了主动脉CT扫描。对两组主动脉造影结果进行盲法比较。结果从1998年1月5日至1999年1月11日，对22例患者和22例对照者进行了主动脉受累的CT扫描。主动脉壁增厚在患者中比对照组更常见（45.4%对13.6%; P = 0.02）。主动脉增厚（平均3.3 mm）位于22.7%的患者的胸主动脉的上升部分，对照组中没有增厚的证据（P = 0.05）。27.3%的患者腹主动脉壁增厚，而对照组无一例（P = 0.02）。这项研究表明，炎症性主动脉增厚，CT扫描检测，经常发生在诊断GCA的时间，这种情况主要发生在升主动脉的一部分。
Objective. The prevalence of the involvement of large vessels in giant cell arteritis (GCA) is 3-13%. Aortitis is the most serious complication of GCA. Computed tomodensitometric (CT) scan allows analysis of both the aortic wall and endoluminal part of the aorta. Therefore, we conducted a study using CT scan to analyze aortic abnormalities in patients with recent-onset GCA.Methods. This prospective controlled study compared patients with biopsy-proven GCA with a matched control group based on sex, age, and cardiovascular risk factors. During the 4-week period following diagnosis of GCA, patients underwent an aortic CT scan. The aortic imaging results were blindly compared between both groups. Results. From January 5, 1998 to January 11, 1999, 22 patients and 22 controls were screened by CT scan for aortic involvement. Thickening of the aortic wall was more frequent among patients than controls (45.4% versus 13.6%; P = 0.02). Aortic thickening (mean 3.3 mm) was located on the ascending part of the thoracic aorta in 22.7% of the patients, with no evidence of thickening in the controls (P = 0.05). Thickening of the abdominal aortic wall was noted in 27.3% of the patients and none of the controls (P = 0.02).Conclusion. This study suggests that inflammatory aortic thickening, detected by CT scan, occurs frequently at the time of diagnosis of GCA, and that this condition predominantly occurs on the ascending part of the aorta.