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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Imaging Features of Thoracic Manifestations of Behçet’s Disease: Beyond Pulmonary Artery Involvement

Author(s): Çisel Yazgan*, Hakan Ertürk and Ayşenaz Taşkın

Volume 17, Issue 8, 2021

Published on: 12 January, 2021

Page: [996 - 1002] Pages: 7

DOI: 10.2174/1573405617999210112193856

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Abstract

Background: Behçet’s disease is a chronic multisystemic vasculitis affecting vessels of different sizes in various organs. Thoracic manifestations of the disease show a wide spectrum involving a variety of anatomic structures within the chest. However, pulmonary artery involvement is a typical manifestation of the disease that contributes significantly to mortality in patients. The study aimed to analyze CT features of thoracic manifestations, particularly pulmonary artery involvement, and to quantitatively assess bronchial arteries in Behçet’s disease.

Methods: Patients with Behçet’s disease who underwent CT scans for suspected thoracic involvement between 2010 and 2018 were included. CT findings of 52 patients were retrospectively analyzed for thoracic manifestations of the disease. Bronchial arteries were assessed regarding diameter in patients with/without pulmonary artery involvement. The pulmonary symptoms were noted.

Results: Of the 52 patients, 67% had thoracic manifestations including pulmonary artery involvement, parenchymal changes, superior vena cava thrombosis, and intracardiac thrombus. Pulmonary artery involvement was observed in 50% of the cohort. Peripheral pulmonary arteries (77%) were the most commonly affected branches, followed by lobar (42%) and central (35%) pulmonary arteries. Other thoracic findings were significantly correlated with pulmonary artery involvement (p<0.05). Compared to patients without pulmonary artery involvement, those with pulmonary artery involvement had a higher bronchial artery diameter (p<0.05) and occurrence rate of dilated bronchial arteries.

Conclusion: Involvement of peripheral pulmonary arteries is frequently encountered in Behçet’s disease and it can resemble pulmonary nodules. Dilated bronchial arteries, which can be observed in cases of pulmonary artery involvement, should be considered in patients with hemoptysis.

Keywords: Behçet’s Disease, imaging features, thoracic manifestation, pulmonary artery, computed tomography, hemoptysis.

Graphical Abstract

[1]
Erkan F, Gül A, Tasali E. Pulmonary manifestations of Behçet’s disease. Thorax 2001; 56(7): 572-8.
[http://dx.doi.org/10.1136/thorax.56.7.572] [PMID: 11413359]
[2]
Zhang X, Dai H, Ma Z, Yang Y, Liu Y. Pulmonary involvement in patients with Behçet’s disease: report of 15 cases. Clin Respir J 2015; 9(4): 414-22.
[http://dx.doi.org/10.1111/crj.12153] [PMID: 24761807]
[3]
Ödev K, Tunç R, Varol S, Aydemir H, Yılmaz PD, Korkmaz C. Thoracic complications in behçet's disease: Imaging findings. Can Respir J 2020; 2020: 4649081.
[4]
Akpolat T, Danaci M, Belet U, Erkan ML, Akar H. MR imaging and MR angiography in vascular Behçet’s disease. Magn Reson Imaging 2000; 18(9): 1089-96.
[http://dx.doi.org/10.1016/S0730-725X(00)00215-0] [PMID: 11118763]
[5]
Erkan F, Kiyan E, Tunaci A. Pulmonary complications of Behçet’s disease. Clin Chest Med 2002; 23(2): 493-503.
[http://dx.doi.org/10.1016/S0272-5231(01)00014-4] [PMID: 12092042]
[6]
Ceylan N, Bayraktaroglu S, Erturk SM, Savas R, Alper H. Pulmonary and vascular manifestations of Behcet disease: imaging findings. AJR Am J Roentgenol 2010; 194(2)
[http://dx.doi.org/10.2214/AJR.09.2763] [PMID: 20093567]
[7]
Chae EJ, Do KH, Seo JB, et al. Radiologic and clinical findings of Behçet disease: comprehensive review of multisystemic involvement. Radiographics 2008; 28(5): 31.
[http://dx.doi.org/10.1148/rg.e31]
[8]
Hiller N, Lieberman S, Chajek-Shaul T, Bar-Ziv J, Shaham D. Thoracic manifestations of Behçet disease at CT. Radiographics 2004; 24(3): 801-8.
[http://dx.doi.org/10.1148/rg.243035091] [PMID: 15143229]
[9]
Mehdipoor G, Davatchi F, Ghoreishian H, Arjmand Shabestari A. Imaging manifestations of Behcet’s disease: Key considerations and major features. Eur J Radiol 2018; 98: 214-25.
[http://dx.doi.org/10.1016/j.ejrad.2017.11.012] [PMID: 29196115]
[10]
Behcet H. Über rezidivierende, aphtöse, durch ein Virus verursachte Geschwüre am Mund, am Auge und an den Genitalien. Dermatol Wochenschr 1937; 105: 1152-63.
[11]
Bang D, Lee JH, Lee ES, et al. Epidemiologic and clinical survey of Behcet’s disease in Korea: the first multicenter study. J Korean Med Sci 2001; 16(5): 615-8.
[http://dx.doi.org/10.3346/jkms.2001.16.5.615] [PMID: 11641532]
[12]
Azizlerli G, Köse AA, Sarica R, et al. Prevalence of Behçet’s disease in Istanbul, Turkey. Int J Dermatol 2003; 42(10): 803-6.
[http://dx.doi.org/10.1046/j.1365-4362.2003.01893.x] [PMID: 14521694]
[13]
Davatchi F, Shahram F, Chams-Davatchi C, et al. Behcet’s disease: from East to West. Clin Rheumatol 2010; 29(8): 823-33.
[http://dx.doi.org/10.1007/s10067-010-1430-6] [PMID: 20354748]
[14]
Edrees A, Naguib S, El Menyawi M, Ismail I, Nagah H. Pulmonary manifestations in a group of patients with Behcet’s disease. Int J Rheum Dis 2017; 20(2): 269-75.
[http://dx.doi.org/10.1111/1756-185X.12626] [PMID: 26354676]
[15]
Seyahi E, Melikoglu M, Akman C, et al. Pulmonary artery involvement and associated lung disease in Behçet disease: a series of 47 patients. Medicine (Baltimore) 2012; 91(1): 35-48.
[http://dx.doi.org/10.1097/MD.0b013e318242ff37] [PMID: 22210555]
[16]
Seyahi E, Yazici H. Behçet’s syndrome: pulmonary vascular disease. Curr Opin Rheumatol 2015; 27(1): 18-23.
[http://dx.doi.org/10.1097/BOR.0000000000000131] [PMID: 25415527]
[17]
Tunaci M, Ozkorkmaz B, Tunaci A, Gül A, Engin G, Acunaş B. CT findings of pulmonary artery aneurysms during treatment for Behçet’s disease. AJR Am J Roentgenol 1999; 172(3): 729-33.
[http://dx.doi.org/10.2214/ajr.172.3.10063870] [PMID: 10063870]
[18]
Yuan SM. Pulmonary artery aneurysms in Behçet disease. J Vasc Bras 2014; 13: 217-28.
[http://dx.doi.org/10.1590/jvb.2014.041]
[19]
Tamagno MF, Castelli JB, Bibas BJ, Minamoto H. Peripheral pulmonary artery aneurysm presenting as a solitary pulmonary nodule. Autops Case Rep 2015; 5(2): 49-53.
[http://dx.doi.org/10.4322/acr.2015.007] [PMID: 26484335]
[20]
Valente T, Abu-Omar A, Sica G, et al. Acquired peripheral pulmonary artery aneurysms: morphological spectrum of disease and multidetector computed tomography angiography findings-cases series and literature review. Radiol Med (Torino) 2018; 123(9): 664-75.
[http://dx.doi.org/10.1007/s11547-018-0900-9] [PMID: 29721920]
[21]
Robinson C, Miller D, Will M, Dhaun N, Walker W. Hughes-Stovin syndrome: the diagnostic and therapeutic challenges of peripheral pulmonary artery aneurysms. QJM 2018; 111(10): 729-30.
[http://dx.doi.org/10.1093/qjmed/hcy110] [PMID: 29860510]
[22]
Greene RM, Saleh A, Taylor AK, et al. Non-invasive assessment of bleeding pulmonary artery aneurysms due to Behçet disease. Eur Radiol 1998; 8(3): 359-63.
[http://dx.doi.org/10.1007/s003300050394] [PMID: 9510565]
[23]
Çimen F. Behçet’s disease with multiple pulmonary nodules. Chest 2016; 150(Suppl.): 686A.
[http://dx.doi.org/10.1016/j.chest.2016.08.781]
[24]
Seyahi E. Behçet’s disease: How to diagnose and treat vascular involvement. Best Pract Res Clin Rheumatol 2016; 30(2): 279-95.
[http://dx.doi.org/10.1016/j.berh.2016.08.002] [PMID: 27886800]
[25]
Takeno M, Ideguchi H, Suda A, et al. Vascular involvement of Behçet’s disease. Behçet’s Disease, from Genetics to Therapies 1st. Berlin, Germany: Springer 2015; pp. 79-100.
[26]
Uzun O, Erkan L, Akpolat I, Findik S, Atici AG, Akpolat T. Pulmonary involvement in Behçet’s disease. Respiration 2008; 75(3): 310-21.
[http://dx.doi.org/10.1159/000101954] [PMID: 17446699]
[27]
Gül A, Yilmazbayhan D, Büyükbabani N, et al. Organizing pneumonia associated with pulmonary artery aneurysms in Behçet’s disease. Rheumatology (Oxford) 1999; 38(12): 1285-9.
[http://dx.doi.org/10.1093/rheumatology/38.12.1285] [PMID: 10587562]
[28]
Tunaci A, Berkmen YM, Gökmen E. Thoracic involvement in Behçet’s disease: pathologic, clinical, and imaging features. AJR Am J Roentgenol 1995; 164(1): 51-6.
[http://dx.doi.org/10.2214/ajr.164.1.7998568] [PMID: 7998568]
[29]
Caglar M, Ergun E, Emri S. 99Tcm-MAA lung scintigraphy in patients with Behçet’s disease: its value and correlation with clinical course and other diagnostic modalities. Nucl Med Commun 2000; 21(2): 171-9.
[http://dx.doi.org/10.1097/00006231-200002000-00009] [PMID: 10758613]
[30]
Gumuser G, Pirildar T, Tarhan S, et al. Technetium-99m-hexamethylpropylene amine oxime lung scintigraphy findings in patients with Behçet’s disease. Nucl Med Commun 2011; 32(5): 363-8.
[http://dx.doi.org/10.1097/MNM.0b013e328341a375] [PMID: 21394049]
[31]
Esatoglu SN, Seyahi E, Ugurlu S, et al. Bronchial artery enlargement may be the cause of recurrent haemoptysis in Behçet’s syndrome patients with pulmonary artery involvement during follow-up. Clin Exp Rheumatol 2016; 34(6)(Suppl. 102): 92-6.
[PMID: 27791952]
[32]
Kızıldağ B, Yurttutan N, Sarıca MA, et al. Insights into chest computed tomography findings in Behcet’s disease. Tuberk Toraks 2018; 66(4): 325-33.
[http://dx.doi.org/10.5578/tt.27936] [PMID: 30683028]

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