The meaning of MSCT – angiography in early detection of visceral arterial lesions in patients with antiphospholipid syndrome

Abstract

Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease which is characterized by arterial and venous thrombosis, fetal loss, and the presence of antiphospholipid antibodies in the serum (aPL). It is characterized by accelerated atherosclerosis and that together with an increased tendency towards thrombosis leading to the occurrence of various vascular events.

The aim of study: The goal of our work is to show the results we obtained in MSCT angiography examination of visceral arteries included patients with PAPS (primary APS) and SAPS (secondary APS), comparing them with a control group.

Methods: In this study we analyzed 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients, who have secondary antiphospholipid syndrome (SAPS). The results were compared to 50 controls. The groups were comparable with respect to age, gender, and traditional risk factors except for the lipid status, since controls had significantly higher levels of cholesterol and triglycerides. Study was conducted on 64-multi-sliced computed tomography (64-MSCT), where we analyzed quantitative and morphological characteristics of blood vessels detected lesions.

Results: Patients from the control group had statistically very significant elevated cholesterol and triglyceride levels in regards to the patients with SAPS and PAPS (p<0.001 and p<0.05). The results showed that the frequency change is statistically (p < 0.05 and p < 0.001) more frequent in patients with APS than in the control group. Analyzing percentage of diameter stenosis, we have establish that lesions from group with 0%-30% DS and 30%-50% DS are in patients with PAPS (n=48) and SAPS (n=42) are more common than in control group (n=20, p<0.05). Analyzing the qualitative characteristics of plaques we have established significant higher frequency of soft tissue (n=21) and mixed lesions (n=25) in patients with PAPS than the calcified one (n=2, p<0.001).

Conclusion: Our study showed that the subclinical manifestation of changes on visceral arteries is more common in patients with APS. Because of its safety and accuracy, the method of choice is 64-MSCT angiography in monitoring disease progression.

Key words: antiphospholipid syndrome, vascular manifestations, 64-multi sliced computed tomography