ab17_2

Non-invasive assessment of pulmonary artery involvement in Takayasu’s arteritis

M. Vanoli¹, M. Castellani², G. Bacchiani¹, G. Calì³, B. Mietner¹, L. Origgi¹, R. Scorza⁴

3rd Division of Internal Medicine¹, Nuclear Medicine Department², Division of Cardiology³, IRCCS Ospedale Maggiore di Milano; and Department of Internal Medicine⁴, Università di Milano, Milan, Italy.

ABSTRACT
Objective
To evaluate pulmonary involvement in Italian patients with Takayasu’s arteritis (TA).

Methods
A prospective analysis of 15 Italian patients with TA was carried out, including evaluation by perfusion and ventilation lung scintigraphy (planar and tomographic), standard chest X-ray, spirography and color-doppler echocardiography. All the patients were free of respiratory symptoms when examined.

Results
In all patients standard chest X-rays and ventilation scintigraphies were normal. 9/15 patients showed unmatched segmental perfusion defects (41 by planar evaluation vs. 48 by SPET). The number of defects was greater in the right lung than in the left (26 vs 18), with a higher frequency of moderate or large defects.
Thirteen patients underwent spirography, which proved to be abnormal in 5 cases. Two of these patients were also positive on scintigraphy. No patient showed alterations attributable to TA on color-doppler echocardiography, except for 3 patients with mild to moderate aortic valve regurgitation.

Conclusions
Our results show that vascular pulmonary involvement is frequent in TA (60% of cases) even in the absence of clinical signs. The planar image, simpler than the SPET to acquire, was sufficient to make an accurate diagnosis. Italian patients seem to show a pattern of extra-pulmonary and pulmonary vascular involvement very similar to that reported in Japanese subjects, and different from that observed in other ethnic groups.

Key words
Takayasu’s arteritis, pulmonary vasculitis, lung scintigraphy.

Please address correspondence and reprint requests to: Massimo Vanoli, MD, Padiglione Granelli, IRCCS Ospedale Maggiore di Milano, Via Francesco Sforza 35, 20122 Milano, Italy.