Identification and characterization of peripheral vascular color-coded DECT lesions in gout and non-gout patients: The VASCURATE study
| Autor: | Hyon K. Choi, Jean-François Budzik, Fabio Becce, Paul Carpentier, V. Ducoulombier, Julie Legrand, Eric Houvenagel, Sébastien Verclytte, Tristan Pascart, Laurène Norberciak, Hélène Luraschi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Gout Arterial calcifications 03 medical and health sciences 0302 clinical medicine Rheumatology Monosodium urate medicine Crystal arthropathy Humans 030212 general & internal medicine 030203 arthritis & rheumatology Arthritis Gouty business.industry Soft tissue medicine.disease INCEPTION COHORT Uric Acid Peripheral Anesthesiology and Pain Medicine Concomitant Radiology Tomography X-Ray Computed business Follow-Up Studies |
| Zdroj: | Seminars in Arthritis and Rheumatism. 51:895-902 |
| ISSN: | 0049-0172 |
| DOI: | 10.1016/j.semarthrit.2021.06.009 |
| Popis: | To characterize peripheral vascular plaques color-coded as monosodium urate (MSU) deposition by dual-energy computed tomography (DECT) and assess their association with the overall soft-tissue MSU crystal burden.Patients with suspected crystal arthropathies were prospectively included in the CRYSTALILLE inception cohort to undergo baseline knees and ankles/feet DECT scans; treatment-naive gout patients initiating treat-to-target urate-lowering therapy (ULT) underwent repeated DECT scans with concomitant serum urate level measurements at 6 and 12 months. We determined the prevalence of DECT-based vascular MSU-coded plaques in knee arteries, and assessed their association with the overall DECT volumes of soft-tissue MSU crystal deposition and coexistence of arterial calcifications. DECT attenuation parameters of vascular MSU-coded plaques were compared with dense calcified plaques, control vessels, control soft tissues, and tophi.We investigated 126 gout patients and 26 controls; 17 ULT-naive gout patients were included in the follow-up study. The prevalence of DECT-based vascular MSU-coded plaques was comparable in gout patients (24.6%) and controls (23.1%; p=0.87). Vascular MSU-coded plaques were strongly associated with coexisting arterial calcifications (p0.001), but not with soft-tissue MSU deposition. Characterization of vascular MSU-coded plaques revealed specific differences in DECT parameters compared with control vessels, control soft tissues, and tophi. During follow-up, vascular MSU-coded plaques remained stable despite effective ULT (p=0.64), which decreased both serum urate levels and soft-tissue MSU volumes (p0.001).Our findings suggest that DECT-based MSU-coded plaques in peripheral arteries are strongly associated with calcifications and may not reflect genuine MSU crystal deposition. Such findings should therefore not be a primary target when managing gout patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect