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Peer-reviewedCC BY-NC-NDPediatric rheumatology online journal

Superb microvascular imaging versus CT angiography for assessing disease activity in pediatric Takayasu arteritis: a comparative study with high consistency.

  • Qiqiong Tang1
  • Chenxi Jia2
  • Jiashuo Wu2
  • Yunlu Tao3
  • Zhenghu Wei1
  • Mingyu Xia4
  • Zankai Ye5
5 affiliations
  1. 1Department of Ultrasound Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
  2. 2Capital Medical University, Beijing, China.
  3. 3Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
  4. 4Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. [email protected].
  5. 5Department of Cardiac Surgery, Beijing Children's Hospital, Capital Medical University, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China. [email protected].
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Abstract

Background

To compare the value and consistency of superb microvascular imaging (SMI) and CT angiography (CTA) for assessing disease activity in pediatric Takayasu arteritis (TA), and to explore the feasibility of SMI as a non-invasive screening tool.Methods

Forty-seven children with TA treated at our hospital between May 2019 and January 2025 were included. Disease activity was determined using the National Institutes of Health (NIH) criteria, and patients were classified into active (n = 26) and inactive (n = 21) groups. All patients underwent both SMI and CTA. The sensitivity, specificity, accuracy, and area under the ROC curve (AUC) of SMI grading and CTA for diagnosing TA activity were analyzed. Kappa tests were used to assess consistency with NIH criteria. Inter-observer agreement for SMI grading was also evaluated.Results

SMI grading was significantly higher in the active group than in the inactive group (Z = 5.388, p < 0.001). Using SMI grade ≥ II as the cutoff, SMI had a sensitivity of 84.62%, specificity of 95.24%, and accuracy of 89.36%. CTA had a sensitivity of 88.46%, specificity of 90.48%, and accuracy of 89.36%. The AUC values were 0.885 for SMI and 0.895 for CTA. SMI showed good consistency with NIH criteria (Kappa = 0.788), as did CTA (Kappa = 0.786). Inter-observer agreement for SMI grading was good (Kappa = 0.865, 95% CI: 0.777-0.953), with 43 of 47 cases (91.49%) showing complete concordance.Conclusions

SMI and CTA demonstrate comparable diagnostic performance and high consistency in assessing disease activity in pediatric TA. Given its non-invasive nature, absence of radiation, no need for contrast agents, and repeatability, SMI is recommended as the preferred screening tool for long-term follow-up of disease activity in pediatric TA, with CTA reserved for cases where SMI suggests activity or when precise vascular assessment is needed.

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Cite

BibTeXRIS
BibTeX
@article{tang2026superb,
  title = {{Superb microvascular imaging versus CT angiography for assessing disease activity in pediatric Takayasu arteritis: a comparative study with high consistency.}},
  author = {Qiqiong Tang and Chenxi Jia and Jiashuo Wu and Yunlu Tao and Zhenghu Wei and Mingyu Xia and Zankai Ye},
  journal = {Pediatric rheumatology online journal},
  year = {2026},
  month = jul,
  doi = {10.1186/s12969-026-01255-y},
  url = {https://europepmc.org/article/MED/42928231},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Superb microvascular imaging versus CT angiography for assessing disease activity in pediatric Takayasu arteritis: a comparative study with high consistency.
AU  - Qiqiong Tang
AU  - Chenxi Jia
AU  - Jiashuo Wu
AU  - Yunlu Tao
AU  - Zhenghu Wei
AU  - Mingyu Xia
AU  - Zankai Ye
PY  - 2026
DA  - 2026/07/29
JO  - Pediatric rheumatology online journal
DO  - 10.1186/s12969-026-01255-y
UR  - https://europepmc.org/article/MED/42928231
AB  - Background  To compare the value and consistency of superb microvascular imaging (SMI) and CT angiography (CTA) for assessing disease activity in pediatric Takayasu arteritis (TA), and to explore the feasibility of SMI as a non-invasive screening tool.Methods  Forty-seven children with TA treated at our hospital between May 2019 and January 2025 were included. Disease activity was determined using the National Institutes of Health (NIH) criteria, and patients were classified into active (n = 26) and inactive (n = 21) groups. All patients underwent both SMI and CTA. The sensitivity, specificity, accuracy, and area under the ROC curve (AUC) of SMI grading and CTA for diagnosing TA activity were analyzed. Kappa tests were used to assess consistency with NIH criteria. Inter-observer agreement for SMI grading was also evaluated.Results  SMI grading was significantly higher in the active group than in the inactive group (Z = 5.388, p < 0.001). Using SMI grade ≥ II as the cutoff, SMI had a sensitivity of 84.62%, specificity of 95.24%, and accuracy of 89.36%. CTA had a sensitivity of 88.46%, specificity of 90.48%, and accuracy of 89.36%. The AUC values were 0.885 for SMI and 0.895 for CTA. SMI showed good consistency with NIH criteria (Kappa = 0.788), as did CTA (Kappa = 0.786). Inter-observer agreement for SMI grading was good (Kappa = 0.865, 95% CI: 0.777-0.953), with 43 of 47 cases (91.49%) showing complete concordance.Conclusions  SMI and CTA demonstrate comparable diagnostic performance and high consistency in assessing disease activity in pediatric TA. Given its non-invasive nature, absence of radiation, no need for contrast agents, and repeatability, SMI is recommended as the preferred screening tool for long-term follow-up of disease activity in pediatric TA, with CTA reserved for cases where SMI suggests activity or when precise vascular assessment is needed.
SN  - 1546-0096
ER  -