scholarly journals POS0520 ASSOCIATIONS BETWEEN THE NEOVASCULARIZATION OF CAROTID ATHEROSCLEROTIC PLAQUES, LIPID PARAMETERS AND IMMUNOLOGICAL DISORDERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 493.3-493
Author(s):  
E. Gerasimova ◽  
T. Popkova ◽  
O. Pogorelova ◽  
O. Fomicheva ◽  
I. Kirillova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Carotid Arteries ◽  
Atherosclerotic Plaques ◽  
Contrast Enhanced Ultrasound ◽  
Immunological Disorders ◽  
Das 28 ◽  
Contrast Enhanced ◽  
Group Ii ◽  
The Relationship ◽  
Lipid Parameters

Background:Development of carotid atherosclerotic plaques (CAP) in patients (pts) with rheumatoid arthritis (RA) is associated with accumulation of traditional risk factors and immunological disorders. CAP neovascularization is associated with its’ inflammation and increasing vulnerability. Therefore, early detection of CAP neovascularization is important for prevention of potential cardiovascular complications, preferably using a non-invasive technique, such as contrast-enhanced ultrasound (CEUS) of the carotid arteries.Objectives:to identify the relationship between the severity of CAP neovascularization, lipid parameters and RA-related parameters.Methods:Evaluation of 23 RA pts, 8 males and 15 females, mean age 61 [58; 65] years, with a longstanding disease (7 [3;12] years), seropositivity for IgM rheumatoid factor (RF) (76%) and anti-cyclic citrullinated peptide (ACCP) (62%) and moderate clinical disease activity (DAS 28 3,9 [3,2;4,8]). Nineteen RA pts (83%) received Methotrexate, 35% - biological agents, 35% - low-dose glucocorticoids. All patients underwent bilateral CEUS of the carotid arteries using a PHILIPS IU22 ultrasound system with 3-9 MHz linear array transducer and i/v administration of SonoVue contrast agent. The severity of carotid intraplaque neovascularization (IPN) was visually assessed on a scale from 0 to 3 (Shah et al. 2007): 0 - no neovascularization, 1 (mild) - limited to moderate neovascularization, 2 (severe) - extensive appearance of neovascularization, 3 - in the presence of a pulsating vessel in the plaque image.Results:Carotid IPN was found in all RA pts. Grade 1 of neovascularization was established in 39% pts (group I) and Grade 2 - in 61% pts (group II). Groups were comparable in terms of age, sex, body mass index, smoking, disease duration and activity RA (DAS 28 score). The degree of carotid IPN positively correlated with the LDL-C level (R = 0,46, p=0,04), and the TG level (R=0,56, p=0,01) and negatively correlated with the HDL-C level (R= -0,52, p=0,02) in all pts. The degree of neovascularization was also associated with RA duration (R=0,52, p<0,05) and ACCP-positivity (R=0,57, p=0,007). Aforementioned correlations were significant for both groups of RA pts. No association was found between the severity of IPN and the levels of RF, DAS28. Association between the degree of carotid stenosis and CRP concentrations (R=-0,73, p<0,05) was found in pts of group II.Conclusion:CEUS of carotid arteries demonstrated the presence of a predominantly extensive carotid IPN in RA pts. Cases of more severe carotid IPN were associated with lipid parameters (positively with the LDL-C, TG levels and negatively with the HDL-C level), RA duration and ACCP-positivity. The relationship between the degree of carotid artery stenosis and CRP requires additional studies to determine the role of immunological disorders in the development of carotid intraplaque neovascularization in RA pts.References:[1]Shah F., Balan P., Weinberg M., Reddy V., Neems R., Feinstein M., Dainauskas J., Meyer P., Goldin M., Feinstein S.B. Contrast-enhanced ultrasound imaging of atherosclerotic carotid plaque neovascularization: a new surrogate marker of atherosclerosis? Vasc Med. 2007;12(4):291-7. https://doi.org/10.1177/1358863x07083363Disclosure of Interests:None declared

Quantification of synovitis in Rheumatoid Arthritis: Do we really need quantitative measurement of contrast-enhanced ultrasound?

2009 ◽  
Vol 71 (2) ◽  
pp. 237-241 ◽  
Author(s):  
Hannes Platzgummer ◽  
Gerd Schueller ◽  
Johannes Grisar ◽  
Michael Weber ◽  
Claudia Schueller-Weidekamm
Keyword(s):  
Rheumatoid Arthritis ◽  
Quantitative Measurement ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

Contrast Enhanced Ultrasound: Visualization of Far Field and Classification of Plaque in the Extracranial Carotid Arteries

2018 ◽  
Vol 42 (3) ◽  
pp. 109-115 ◽  
Author(s):  
Paige L. Rowland ◽  
Michelle Colpitts ◽  
Angela Malone ◽  
Munis Raza ◽  
Lenora L. Eberhart ◽  
...  
Keyword(s):  
Image Quality ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Carotid Artery Disease ◽  
Plaque Morphology ◽  
Far Field ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Imaging ◽  
Contrast Enhanced ◽  
Artery Disease

Ultrasound stratification for the degree of carotid artery disease based solely on lumen reduction has poorly predicted patient outcomes. This pilot study focused on patients with moderate carotid artery stenosis. Our purpose was to use contrast imaging with ultrasound to improve carotid field. A total of 10 patients diagnosed with moderate carotid artery stenosis were rescanned with an administration of a contrast imaging agent. Two-dimensional (2D) imaging, color, and Doppler were utilized to scan the patients. The 20 carotid arteries were blindly read by 2 experienced physicians. Visualization of far field, quality of Doppler envelope, plaque morphology, and overall image quality were semi-quantifiably assessed. With the use of a contrast imaging agent, there was a reduction in interphysician interpretation variability. The Kappa coefficient yielded an increase in agreement for postcontrast imaging in the majority of variables. The Doppler envelope showed improvement from precontrast (0.06) to postcontrast (0.63). The visualization of the far fields demonstrated a significant increase in agreement (0.77, 0.71, and 0.67) postcontrast. Plaque morphology demonstrated enhancement in characterization with contrast (–0.09 to 0.66). In this study, contrast-enhanced ultrasound (CEUS) was found to increase overall image quality. Improved interpretation can enhance risk stratification and with further exploration could be used to guide treatment plans for patients with asymptomatic moderate carotid artery disease.

An increase in activated NKT-CD8+ cells is associated with the presence of hypoechoic carotid plaques

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Genkel ◽  
I Baturina ◽  
I Emelyanov ◽  
I Shaposhnik ◽  
I Dolgushin
Keyword(s):  
Carotid Arteries ◽  
Roc Analysis ◽  
Carotid Atherosclerosis ◽  
Duplex Ultrasound ◽  
Atherosclerotic Plaques ◽  
Carotid Plaques ◽  
Cd8 Cells ◽  
The Relationship ◽  
Pro Inflammatory Cytokines

Abstract Background The role of NK-cells and NKT-cells and their subtypes at various stages of the development of atherosclerosis is poorly understood. It was previously shown that CD3+CD56+CD8+ cells can secrete pro-inflammatory cytokines and an increase in their number has been established in patients with active Behçet's Disease and Multiple Sclerosis. Purpose To study the relationship between the number of activated CD3+CD56+CD8+ cells and the echogenicity of plaques in patients with carotid atherosclerosis. Methods The study included 40 patients, 21 (52.5%) men and 19 (47.5%) women who underwent carotid ultrasound and immunological studies. The median age was 53.5 (46.7; 57.0) years. All patients underwent duplex ultrasound scanning of the carotid arteries. If an atherosclerotic plaque was detected, its image was saved and exported to Adobe Photoshop CS6® followed by analysis of the gray-scale median (GSM) of the plaque. Hypoechoic was considered a carotid plaque whose GSM values were less than 50. The number of CD3+CD56+CD8+CD11b+ cells was evaluated by flow cytometry using a flow cytometer. Results Among the examined patients, carotid plaques were detected in 31 (77.5%) participants. The average values of GSM visualized plaques were 58.0 (46.0; 71.5). Atherosclerotic plaques with GSM &lt;50 were detected in 11 (35.5%) patients. In patients with hypoechoic carotid plaques, the number of CD3+CD56+CD8+CD11b+ cells was statistically significantly higher – 352 (55.0; 505) cells/uL versus 66.0 (15.5; 138) cells/uL in patients with plaques whose GSM values were more than 50 (p=0.020). Based on the results of correlation analysis it was established inverse relationship between number of CD3+CD56+CD8+CD11b+ cells and GSM of plaques (r=−0.427; p=0.016). According to the results of the ROC-analysis, an increase in the number of activated NKT-CD8+ cells over 46.5 cells/uL was a predictor of the presence of hypoechogenic carotid plaques with a sensitivity of 81.8% and a specificity of 45.0% (see Figure 1). Conclusion In patients with hypoechoic carotid plaques, the number of CD3+CD56+CD8+CD11b+ cells was significantly higher in comparison with other patients. An increase in the number of activated NKT-CD8+ cells over 46.5 cells/uL was a predictor of the presence of hypoechoic carotid plaques with sensitivity of 81.8% and specificity of 45.0% Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals The Value of Peripheral Enhancement Pattern for Diagnosing Thyroid Cancer Using Contrast-Enhanced Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yan Zhang ◽  
Ming-bo Zhang ◽  
Yu-kun Luo ◽  
Jie Li ◽  
Zhi-li Wang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Peripheral Ring ◽  
Conventional Ultrasound ◽  
Relationship Of ◽  
Peripheral Enhancement ◽  
The Relationship

Background. Contrast-enhanced ultrasound (CEUS) scanning can detect differences between thyroid tumors and surrounding tissues. However, enhancement patterns within nodules are insufficient for the diagnosis of thyroid carcinomas. The peripheral enhancement patterns of nodules may provide useful diagnostic information. The objective of this study was to investigate the diagnostic accuracy of the peripheral enhancement patterns during CEUS scanning of thyroid nodules. Material and Methods. 120 nodules with peripheral rings during CEUS and definite pathology confirmed by surgery were included in this study. The internal and peripheral CEUS enhancement patterns of these nodules were assessed, and the diagnostic value of CEUS was compared with the conventional ultrasound. The relationship of types of peripheral rings and sizes of nodules was analyzed, respectively. Results. There were 78 benign and 42 malignant nodules. Peripheral irregular ring performs well in detecting malignancy. It improves the diagnostic performance of CEUS by combining with internal enhancement patterns (diagnostic sensitivity of 97.6%, specificity of 98.7%, and accuracy of 98.3%) and adds value to conventional ultrasound (95.2%, 70.5%, and 79.2%). The sizes of the nodules with regular high-enhanced rings (2.34 ± 1.33 cm) were larger than the other three types of peripheral rings (P<0.05). Conclusions. Features of peripheral ring on CEUS are important for the diagnosis of thyroid cancer; they can further contribute to the accuracy combining with the internal enhancement pattern, which could avoid the unnecessary biopsy.

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