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.