Современные возможности визуализации сосудистого повреждения при системных васкулитах крупных сосудов

Инструментальные методы визуализации сосудистого повреждения имеют ключевое значение для диагностики системных васкулитов (СВ) крупных сосудов, оценки эффективности лечения и раннего выявления рецидивов. Несмотря на стремительное развитие ревматологии с углублением представлений о патогенезе СВ, внедрением инновационных стратегий лечения и расширением методов диагностики, в настоящее время не существует универсального метода визуализации, который мог бы предоставить исчерпывающую информацию о состоянии крупных сосудов. Стандартизация инструментальных методов для оценки степени активности и диагностика рецидива относятся к ключевым нерешенным проблемам ведения пациентов с СВ крупных сосудов. В 2018 году были опубликованы рекомендации Европейской антиревматической лиги (EULAR, European League Against Rheumatism), осветившие широкий круг проблем визуализации поражения крупных сосудов при СВ, которые стали результатом систематизированного анализа современных научных достижений и клинического опыта. Целью данной публикации является обобщение современных возможностей инструментального обследования больных системными васкулитами крупных сосудов с общей характеристикой основных положений рекомендаций EULAR и обсуждением некоторых дискуссионных вопросов.

1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Arthritis Rheum. 2013;65(1):1-11. doi: 10.1002/art.37715

2. Zarka F, Veillette C, Makhzoum JP. A review of primary vasculitis mimickers based on the Chapel Hill Consensus classification. Int J Rheumatol. 2020;2020:8392542. doi: 10.1155/2020/8392542

3. Peng L, Zhang P, Li J, Liu Z, Lu H, Zhu L, et al. IgG4-related aortitis/periaortitis and periarteritis: A distinct spectrum of IgG4- related disease. Arthritis Res Ther. 2020;22(1):103. doi: 10.1186/s13075-020-02197-w

4. Corominas H, Tsokos M, Quezado M, Tsokos GC. Aneurysm of the ascending aorta in systemic lupus erythematosus: Case report and review of the literature. Eur J Rheumatol. 2017;4(2):133-135. doi: 10.5152/eurjrheum.2017.17066

5. Willett WF 3rd, Kahn MJ, Gerber MA. Lupus aortitis: A case report and review of the literature. J La State Med Soc. 1996;148(2):55-59.

6. Kaneko S, Yamashita H, Sugimori Y, Takahashi Y, Kaneko H, Kano T, et al. Rheumatoid arthritis-associated aortitis: A case report and literature review. Springerplus. 2014;3:509. doi: 10.1186/2193-1801-3-509

7. Shimizu T, Sato A, Sakamoto K, Seino Y, Kijima M, Matsumoto T, et al. Intravascular ultrasound imaging of isolated and non aorto-ostial coronary Takayasu arteritis: A case report. BMC Cardiovasc Disord. 2020;20(1):260. doi: 10.1186/s12872-020-01541-x

8. Batra K, Chamarthy M, Chate RC, Jordan K, Kay FU. Pulmonary vasculitis: diagnosis and endovascular therapy. Cardiovasc Diagn Ther. 2018;8(3):297-315. doi: 10.21037/cdt.2017.12.06

9. Sharma BK, Jain S, Suri S, Numano F. Diagnostic criteria for Takayasu arteritis. Int J Cardiol. 1996;54(Suppl):S141-S147.

10. Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: New classification. Int J Cardiol. 1996;54(Suppl):S155-S163.

11. Moriwaki R, Noda M, Yajima M, Sharma BK, Numano F. Clinical manifestations of Takayasu arteritis in India and Japan – new classification of angiographic findings. Angiology. 1997;48(5):369-379. doi: 10.1177/000331979704800501

12. Покровский АВ, Зотиков АЕ, Юдин ВИ. Неспецифический аортоартериит (болезнь Такаясу). М.:ИРСИСЪ;2002. [Pokrovskii AV, Zotikov AE, Yudin VI. Nonspecific aortoarteritis (Takayasu’s disease). Moscow:IRSIS;2002 (In Russ.)].

13. Hong S, Bae SH, Ahn SM, Lim DH, Kim YG, Lee CK, et al. Outcome of Takayasu arteritis with inactive disease at diagnosis: The extent of vascular involvement as a predictor of activation. J Rheumatol. 2015;42(3):489-494. doi: 10.3899/jrheum.140981

14. Blockmans D, Coudyzer W, Vanderschueren S, Stroobants S, Loeckx D, Heye S, et al. Relationship between fluorodeoxyglucose uptake in the large vessels and late aortic diameter in giant cell arteritis. Rheumatology (Oxford). 2008;47(8):1179-1184. doi: 10.1093/rheumatology/ken119

15. Robson JC, Kiran A, Maskell J, Hutchings A, Arden N, Dasgupta B, et al. The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. Ann Rheum Dis. 2015;74(1):129-135. doi: 10.1136/annrheumdis-2013-204113

16. Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018;77(5):636-643. doi: 10.1136/annrheumdis-2017-212649

17. Hellmich B, Agueda A, Monti S, Buttgereit F, de Boysson H, Brouwer E, et al. 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020;79(1):19-30. doi: 10.1136/annrheumdis-2019-215672

18. Duftner C, Dejaco C, Sepriano A, Falzon L, Schmidt WA, Ramiro S. Imaging in diagnosis, outcome prediction and monitoring of large vessel vasculitis: A systematic literature review and meta-analysis informing the EULAR recommendations. RMD Open. 2018;4(1):e000612. doi: 10.1136/rmdopen-2017-000612

19. Aschwanden M, Daikeler T, Kesten F, Baldi T, Benz D, Tyndall A, et al. Temporal artery compression sign – A novel ultrasound finding for the diagnosis of giant cell arteritis. Ultraschall Med. 2013;34(1):47-50. doi: 10.1055/s-0032-1312821

20. Aschwanden M, Imfeld S, Staub D, Baldi T, Walker UA, Berger CT, et al. The ultrasound compression sign to diagnose temporal giant cell arteritis shows an excellent interobserver agreement. Clin Exp Rheumatol. 2015;33(2 Suppl 89):S113-S115.

21. Salvarani C, Cantini F, Boiardi L, Hunder G. Laboratory investigations useful in giant cell arteritis and Takayasuэs arteritis. Clin Exp Rheum. 2003;21(6 Suppl 32):23-28.

22. Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919-929. doi: 10.7326/0003-4819-120-11-199406010-00004

23. Xenitidis T, Horger M, Zeh G, Kanz L, Henes JC. Sustained inflammation of the aortic wall despite tocilizumab treatment in two cases of Takayasu arteritis. Rheumatology (Oxford). 2013;52(9):1729-1731. doi: 10.1093/rheumatology/ket107

24. Spira D, Xenitidis T, Henes J, Horger M. MRI parametric monitoring of biological therapies in primary large vessel vasculitides: A pilot study. Br J Radiol. 2016;89(1058):20150892. doi: 10.1259/bjr.20150892

25. García-Martínez A, Arguis P, Prieto-González S, EspígolFrigolé G, Alba MA, Butjosa M, et al. Prospective long term follow-up of a cohort of patients with giant cell arteritis screened for aortic structural damage (aneurysm or dilatation). Ann Rheum Dis. 2014;73(10):1826-1832. doi: 10.1136/annrheumdis-2013-203322

26. Mavrogeni S, Dimitroulas T, Chatziioannou SN, Kitas G. The role of multimodality imaging in the evaluation of Takayasu arteritis. Semin Arthritis Rheum. 2013;42(4):401-412. doi: 10.1016/j.semarthrit.2012.07.005

27. Schmidt WA. Imaging in vasculitis. Best Pract Res Clin Rheumatol. 2013;27:107-118. doi: 10.1016/j.berh.2013.01.001

28. Muratore F, Pipitone N, Salvarani C, Schmidt WA. Imaging of vasculitis: State of the art. Best Pract Res Clin Rheumatol. 2016;30(4):688-706. doi: 10.1016/j.berh.2016.09.010

29. Germanò G, Monti S, Ponte C, Possemato N, Caporali R, Salvarani C, et al. The role of ultrasound in the diagnosis and follow-up of large-vessel vasculitis: An update. Clin Exp Rheumatol. 2017;35(Suppl 103(1)):194-198.

30. Schmidt WA, Kraft HE, Vorpahl K, Völker L, Gromnica-Ihle EJ. Color duplex ultrasonography in the diagnosis of temporal arteritis. N Engl J Med. 1997;337(19):1336-1342. doi: 10.1056/NEJM199711063371902

31. Karahaliou M, Vaiopoulos G, Papaspyrou S, Kanakis MA, Revenas K, Sfikakis PP. Colour duplex sonography of temporal arteries before decision for biopsy: a prospective study in 55 patients with suspected giant cell arteritis. Arthritis Res Ther. 2006;8(4):R116. doi: 10.1186/ar2003

32. De Miguel E, Roxo A, Castillo C, Peiteado D, Villalba A, MartínMola E. The utility and sensitivity of colour Doppler ultrasound in monitoring changes in giant cell arteritis. Clin Exp Rheumatol. 2012;30(1 Suppl 70):S34-S38.

33. Habib HM, Essa AA, Hassan AA. Color duplex ultrasonography of temporal arteries: Role in diagnosis and follow-up of suspected cases of temporal arteritis. Clin Rheumatol. 2012;31:231-237. doi: 10.1007/s10067-011-1808-0

34. Pérez López J, Solans Laqué R, Bosch Gil JA, Molina Cateriano C, Huguet Redecilla P, Vilardell Tarrés M. Colour-duplex ultrasonography of the temporal and ophthalmic arteries in the diagnosis and follow-up of giant cell arteritis. Clin Exp Rheumatol. 2009;27(1 Suppl 52):S77-S82.

35. Schmidt WA, Moll A, Seifert A, Schicke B, Gromnica-Ihle E, Krause A. Prognosis of large-vessel giant cell arteritis. Rheumatology (Oxford). 2008;47(9):1406-1408. doi: 10.1093/rheumatology/ken258

36. Pipitone N, Versari A, Hunder GG, Salvarani C. Role of imaging in the diagnosis of large and medium-sized vessel vasculitis. Rheum Dis Clin North Am. 2013;39:593-608. doi: 10.1016/j.rdc.2013.02.002

37. Prieto-González S, Arguis P, Cid MC. Imaging in systemic vasculitis. Curr Opin Rheumatol. 2015;27:53-62. doi: 10.1097/BOR.0000000000000130

38. Blockmans D, de Ceuninck L, Vanderschueren S, Knockaert D, Mortelmans L, Bobbaers H. Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: A prospective study of 35 patients. Arthritis Rheum. 2006;55(1):131-137. doi: 10.1002/art.21699

39. Lariviere D, Benali K, Coustet B, Pasi N, Hyafil F, Klein I, et al. Positron emission tomography and computed tomography angiography for the diagnosis of giant cell arteritis: A real-life prospective study. Medicine (Baltimore). 2016;95(30):e4146. doi: 10.1097/MD.0000000000004146

40. Blockmans D, Stroobants S, Maes A, Mortelmans L. Positron emission tomography in giant cell arteritis and polymyalgia rheumatica: Evidence for inflammation of the aortic arch. Am J Med. 2000;108(3):246-249. doi: 10.1016/s0002-9343(99)00424-6

41. Puppo C, Massollo M, Paparo F, Camellino D, Piccardo A, Shoushtari Zadeh Naseri M, et al. Giant cell arteritis: A systematic review of the qualitative and semiquantitative methods to assess vasculitis with 18F-fluorodeoxyglucose positron emission tomography. Biomed Res Int. 2014;2014:574248. doi: 10.1155/2014/574248

42. Bucci M, Aparici CM, Hawkins R, Bacharach S, Schrek C, Cheng S, et al. Validation of FDG uptake in the arterial wall as an imaging biomarker of atherosclerotic plaques with 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT). J Neuroimaging. 2014;24(2):117-123. doi: 10.1111/j.1552-6569.2012.00740.x

43. Direskeneli H. Clinical assessment in Takayasu’s arteritis: Major challenges and controversies. Clin Exp Rheumatol. 2017;35:189-193.

44. Oura K, Yamaguchi Oura M, Itabashi R, Maeda T. Vascular Imaging Techniques to Diagnose and Monitor Patients with Takayasu Arteritis: A Review of the Literature. Diagnostics (Basel). 2021;11(11):1993. doi: 10.3390/diagnostics11111993.

45. Park JH, Chung JW, Lee KW, Park YB, Han MC. CT angiography of Takayasu arteritis: Comparison with conventional angiography. J Vasc Interv Radiol. 1997;8(3):393-400. doi: 10.1016/s1051-0443(97)70579-7

46. Paul JF, Fiessinger JN, Sapoval M, Hernigou A, Mousseaux E, Emmerich J, et al. Follow-up electron beam CT for the management of early phase Takayasu arteritis. J Comput Assist Tomogr. 2001;25(6):924-931. doi: 10.1097/00004728-200111000-00015

47. Yamada I, Nakagawa T, Himeno Y, Numano F, Shibuya H. Takayasu arteritis: Evaluation of the thoracic aorta with CT angiography. Radiology. 1998;209(1):103-109. doi: 10.1148/radiology.209.1.9769819

48. Li D, Lin J, Yan F. Detecting disease extent and activity of Takayasu arteritis using whole-body magnetic resonance angiography and vessel wall imaging as a 1-stop solution. J Comput Assist Tomogr. 2011;35:468-474. doi: 10.1148/radiology.209.1.9769819

49. Yamada I, Nakagawa T, Himeno Y, Kobayashi Y, Numano F, Shibuya H. Takayasu arteritis: Diagnosis with breath-hold contrast-enhanced three-dimensional MR angiography. J Magn Reson Imaging. 2000;11(5):481-487. doi: 10.1002/(sici)1522-2586(200005)11:5<481::aid-jmri3>3.0.co;2-4

50. Salvarani C, Silingardi M, Ghirarduzzi A, Lo Scocco G, Macchioni P, Bajocchi G, et al. Is duplex ultrasonography useful for the diagnosis of giant-cell arteritis? Ann Intern Med. 2002;137(4):232-238. doi: 10.7326/0003-4819-137-4-200208200-00006

51. Bley TA, Reinhard M, Hauenstein C, Markl M, Warnatz K, Hetzel A, et al. Comparison of duplex sonography and high-resolution magnetic resonance imaging in the diagnosis of giant cell (temporal) arteritis. Arthritis Rheum. 2008;58(8):2574-2578. doi: 10.1002/art.23699

52. Zhang B, Liang L, Chen W, Liang C, Zhang S. An updated study to determine association between gadolinium-based contrast agents and nephrogenic systemic fibrosis. PLoS One. 2015;10(6):e0129720. doi: 10.1371/journal.pone.0129720

53. Kanda T, Nakai Y, Hagiwara A, Oba H, Toyoda K, Furui S. Distribution and chemical forms of gadolinium in the brain: A review. Br J Radiol. 2017;90(1079):20170115. doi: 10.1259/bjr.20170115

54. OCEBM Levels of Evidence Working Group. The Oxford 2011 levels of evidence. 2011. URL: http://www.cebm.net/index.aspx-?o=5653.

55. Diamantopoulos AP, Haugeberg G, Hetland H, Soldal DM, Bie R, Myklebust G. Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: A consecutive case series. Arthritis Care Res (Hoboken). 2014;66(1):113-119. doi: 10.1002/acr.22178

56. Gülcü A, Gezer NS, Akar S, Akkoç N, Önen F, Göktay AY. Longterm follow-up of endovascular repair in the management of arterial stenosis caused by Takayasu’s arteritis. Ann Vasc Surg. 2017;42:93-100. doi: 10.1016/j.avsg.2016.10.066

57. De Miguel E, Castillo C, Rodríguez A, De Agustín JJ; Working Group Ultrasound Giant Cell Arteritis. Learning and reliability of colour Doppler ultrasound in giant cell arteritis. Clin Exp Rheumatol. 2009;27(1 Suppl 52):S53-S58.

58. Svensson C, Eriksson P, Zachrisson H. Vascular ultrasound for monitoring of inflammatory activity in Takayasu arteritis. Clin Physiol Funct Imaging. 2020;40(1):37-45. doi: 10.1111/cpf.12601

59. Magnoni M, Dagna L, Coli S, Cianflone D, Sabbadini MG, Maseri A. Assessment of Takayasu arteritis activity by carotid contrast-enhanced ultrasound. Circ Cardiovasc Imaging. 2011;4(2):e1- e2. doi: 10.1161/CIRCIMAGING.110.960906

60. Giordana P, Baqué-Juston MC, Jeandel PY, Mondot L, Hirlemann J, Padovani B, et al. Contrast-enhanced ultrasound of carotid artery wall in Takayasu disease: First evidence of application in diagnosis and monitoring of response to treatment. Circulation. 2011;124(2):245-247. doi: 10.1161/CIRCULATIONAHA.110.006668

61. Possemato N, Macchioni P, Germanò G, Pipitone N, Versari A, Salvarani C. Clinical images: PET-CT and contrast-enhanced ultrasound in Takayasu’s arteritis. Rheumatology (Oxford). 2014;53(3):447. doi: 10.1093/rheumatology/ket332

62. Schinkel AF, van den Oord SC, van der Steen AF, van Laar JA, Sijbrands EJ. Utility of contrast-enhanced ultrasound for the assessment of the carotid artery wall in patients with Takayasu or giant cell arteritis. Eur Heart J Cardiovasc Imaging. 2014;15:541-546. doi: 10.1093/ehjci/jet243