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. 2023 Aug;9(3):e003278.
doi: 10.1136/rmdopen-2023-003278.

Prevalence and distribution of vascular calcifications at CT scan in patients with and without large vessel vasculitis: a matched cross-sectional study

Giulia Besutti #  1   2 , Chiara Marvisi #  3   4 , Pamela Mancuso  5 , Roberto Farì  6   3 , Filippo Monelli  1   3 , Matteo Revelli  1 , Rexhep Durmo  3   7 , Elena Galli  4   8 , Francesco Muratore  4   8 , Lucia Spaggiari  1 , Marta Ottone  5 , Stefano Luminari  8   9 , Pierpaolo Pattacini  1 , Paolo Giorgi Rossi  5 , Carlo Salvarani  4   8
Affiliations

Prevalence and distribution of vascular calcifications at CT scan in patients with and without large vessel vasculitis: a matched cross-sectional study

Giulia Besutti et al. RMD Open. 2023 Aug.

Abstract

Objectives: The aim of this study was to compare the prevalence, entity and local distribution of arterial wall calcifications evaluated on CT scans in patients with large vessel vasculitis (LVV) and patients with lymphoma as reference for the population without LVV.

Methods: All consecutive patients diagnosed with LVVs with available baseline positron emission tomography-CT (PET-CT) scan performed between 2007 and 2019 were included; non-LVV patients were lymphoma patients matched by age (±5 years), sex and year of baseline PET-CT (≤2013; >2013). CT images derived from baseline PET-CT scans of both patient groups were retrospectively reviewed by a single radiologist who, after setting a threshold of minimum 130 Hounsfield units, semiautomatically computed vascular calcifications in three separate locations (coronaries, thoracic and abdominal arteries), quantified as Agatston and volume scores.

Results: A total of 266 patients were included. Abdominal artery calcifications were equally distributed (mean volume 3220 in LVVs and 2712 in lymphomas). Being in the LVVs group was associated with the presence of thoracic calcifications after adjusting by age and year of diagnosis (OR 4.13, 95% CI 1.35 to 12.66; p=0.013). Similarly, LVVs group was significantly associated with the volume score in the thoracic arteries (p=0.048). In patients >50 years old, calcifications in the coronaries were more extended in non-LVV patients (p=0.027 for volume).

Conclusion: When compared with patients without LVVs, LVVs patients have higher calcifications in the thoracic arteries, but not in coronary and abdominal arteries.

Keywords: atherosclerosis; giant cell arteritis; systemic vasculitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart representing patient inclusion in LVV and non-LVV groups. LVV, large vessel vasculitis; PET-CT, positron emission tomography-CT.
Figure 2
Figure 2
Distribution of the volume of calcifications in coronary, thoracic and abdominal vessels in the LVV group (including non-matched patients) and lymphoma group. LVV, large vessel vasculitis.
Figure 3
Figure 3
Multiplanar reconstructions on the sagittal (A) and coronal (B) plane, and volume rendering reconstructions of the CT images of representative PET-CT scan of an LVV patient (A) and a non-LVV patient (B). Calcification burden in the thoracic aorta was much higher in the patient with LVV. LVV, large vessel vasculitis; PET-CT, positron emission tomography-CT.
Figure 4
Figure 4
PET-CT images comparing the aortic calcium plaque density in an LVV patient (A,B) and a non-LVV patient (C,D). LVV patient exhibit consistently high plaque density (> 800 HU) as evident in the long axis sagittal view (A) and short axis axial view (B). In contrast, the plaque density in this lymphoma is notably lower (around 400 HU), as illustrated in the long axis sagittal view (C) and short axis axial view (D). HU, Hounsfield units; LVV, large vessel vasculitis; PET-CT, positron emission tomography-CT.
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