Can Measurements of Whole Wall and Intima-Media Thickness of Lower Extremity Veins Really Be Used to Diagnose Behcet's Disease?

OBJECTIVES

This study aimed to investigate the diagnostic performance of measuring intima-media thickness (IMT) and whole wall thickness (WWT) of deep and superficial veins in the lower extremity of Behcet's disease (BD).

METHODS

This cross-sectional study included 67 Behcet patients and 64 healthy control subjects. IMT and WWT of the common femoral (CFV) and great saphenous veins (GSV) were measured by a blinded radiologist using ultrasound. Behcet patients were classified into two groups, namely the vascular and non-vascular groups. The diagnostic performance of the measurements of vein wall thickness in BD was assessed using receiver operating analysis.

RESULTS

Bilateral IMT and WWT of the CFV and GSV were significantly higher in BD than in controls (p < 0.01). In the vascular Behcet group, all measurements were also significantly increased compared with the non-vascular Behcet patients (p < 0.01). The area under the curve for all measurements was satisfactory, while CFV WWT indicated the best diagnostic performance [0.82 (0.74-0.89; 95% CI: p < 0.001) for right; 0.81 (0.74-0.88; 95% CI: p < 0.001) for left] for optimal cut-off value (0.595-0.585 mm; sensitivity = 77.3%-77.6%, specificity = 76.2%-76.6% for right and left, respectively). In the regression analysis, older age, vascular presentation, presence of uveitis, and glucocorticoid use were significantly related to vein wall thickness in BD (p < 0.05).

CONCLUSIONS

The results of this study provide compelling evidence supporting the use of vein wall thickness (primarily in CFV WWT) as a diagnostic method in BD. Furthermore, the study indicates that the optimal cut-off value of vein wall thickness may vary depending on the characteristics of Behcet cohort.