The actual diagnostic utility of vascular wall thickness in Behçet's syndrome

Objective: In many studies conducted on Behçet's syndrome (BS), measurement of venous wall thickness (VWT) by ultrasonography has been proposed as a potential diagnostic tool to distinguish BS from other diseases. The best method to evaluate the diagnostic value of VWT measurement would be to measure VWT in patients presenting with suspected BS and to determine sensitivity and specificity based on the measurements of those diagnosed with and without BS. Methods: All individuals who presented to our clinic for BS screening between May 2023 and December 2023 were included in the study. In addition, 30 vascular BS patients with lower extremity deep vein thrombosis (DVT) and 36 healthy individuals were enrolled. Two radiologists, blinded to the diagnoses, independently measured the wall thickness of the CFV (common femoral vein), GSV (great saphenous vein), and SSV (small saphenous vein). Results: Among the 84 individuals screened for suspected BS, 45 were diagnosed with BS, and 39 were diagnosed with non-BS diseases. The median CFV thickness was highest in vascular BS patients [right: 0.76 mm (0.63–0.87), left: 0.71 mm (0.62–0.86)], followed by BS patients diagnosed during screening [right: 0.59 mm (0.53–0.69), left: 0.60 mm (0.50–0.68)], non-BS patients [right: 0.58 mm (0.50–0.66), left: 0.57 mm (0.49–0.67)], and healthy individuals [right: 0.49 mm (0.47–0.53), left: 0.48 mm (0.43–0.50)]. There was no significant difference between BS and non-BS patients who presented for screening. Conclusion: The venous wall was thicker in both BS and non-BS patients compared to healthy individuals. However, VWT measurement did not show a discriminative difference between BS and other diseases in patients referred to our clinic with suspected BS. The significantly increased VWT in vascular BS patients raises the question of whether this is due to inflammation of the vascular wall or vascular remodeling.