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Contrast-enhanced ultrasound of carotid artery wall in Takayasu disease: first evidence of application in diagnosis and monitoring of response to treatment.

A 35-year-old woman with chronic anterior cervicalgia was referred to our institution for an ultrasound of the neck. The B-mode ultrasound (Siemens S 2000, linear phased array probe 9 to 13 MHz) revealed a 1.6-mm hyperechoic circumferential wall thickening of the right common carotid artery, involving the whole artery, without evidence of stenosis (Figure 1). The other supraaortic arteries appeared normal. Positron-emission tomography and computed tomography scans demonstrated further localizations of arterial wall thickening in the right brachiocephalic artery, the aortic arch, and the abdominal aorta. The patient’s long medical history of hypertension, carotidynia, radial pulse asymmetry, and biological inflammatory syndrome along with the imaging results led to the diagnosis of Takayasu disease.1



Figure 1. 
Mode-B ultrasound: right common carotid artery circumferential wall thickening suggesting inflammatory arteritis.



Contrast-enhanced ultrasound of carotid arteries was then performed (T0) before the patient started steroid treatment. We used …