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

Objective To evaluate pulmonary involvement in Italian patients with Takayasu's arter itis (TA). Methods A prospective analysis of 15 Italian patients with TA wa s carried out, including evaluation by perfusion and ventilation lung scint igraphy (planar and tomographic), standard chest X-ray, spirography and col or-doppler echocardiography. All the patients were free of respiratory symp toms when examined. Results In all patients standard chest X-rays and ventilation scintigraphies were n ormal. 9/15 patients showed unmatched segmental perfusion defects (41 by pl anar evaluation vs. 48 by SPET). The number of defects was greater in the r ight lung than in the left (26 vs 18), with a higher frequency of moderate or lar ge defects. Thirteen patients underwent spirography, which proved to be abnormal in 5 cases. Two of these patients were also positive on scinti graphy. No patient showed alterations attributable to TA on color-doppler e chocardiography, except for 3 patients with mild to moderate aortic valve r egurgitation. 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. It alian patients seem to show a pattern of extra-pulmonary and pulmonary vasc ular involvement very similar to that reported in Japanese subjects and dif ferent from that observed in other ethnic groups.