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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
[Imaging procedures for giant cell arteritis (Horton's disease)]
T A Bley1, I Brink, M Reinhard
1Abteilung Röntgendiagnostik und Medizinphysik, Universitätsklinikum, Hugstetter Strasse 55, 79106 Freiburg. thorsten.bley@uniklinik-freiburg.de
Insights
This review compares diagnostic imaging for giant cell arteritis. High-resolution MRI shows promise for detailed assessment of cranial arteries and extracranial large vessel involvement.
Area of Science:
- Rheumatology
- Radiology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) is a vasculitis affecting large arteries.
- Accurate diagnosis relies on appropriate imaging modalities.
Purpose of the Study:
- To review and compare diagnostic imaging techniques for GCA.
- To evaluate the strengths and limitations of each modality.
Main Methods:
- Review of current literature on diagnostic imaging in GCA.
- Discussion of Color-coded Duplex sonography, Positron Emission Tomography (PET), and High-resolution Magnetic Resonance Imaging (MRI).
Main Results:
- Color-coded Duplex sonography is cost-efficient but observer-dependent, with challenges in differentiating inflammatory from atherosclerotic changes.
- PET is sensitive for extracranial large vessel vasculitis but does not assess superficial cranial arteries.
- High-resolution MRI offers detailed, observer-independent visualization of superficial cranial arteries and extracranial large arteries.
Conclusions:
- High-resolution MRI is a promising new method for GCA diagnosis, offering detailed assessment.
- Further multicenter trials are needed to validate the utility of high-resolution MRI in GCA.
Abstract:
This review article highlights several diagnostic imaging modalities in giant cell arteritis. Color-coded Duplex sonography is a relatively cost-efficient but strongly observer-dependent imaging modality. It may be difficult to distinguish inflammatory from atherosclerotic mural changes. Positron emission tomography with (18)F-fluoro-2-deoxy-D-glucose is very sensitive in detecting extracranial involvement of large vessel vasculitis. However, it provides no information on inflammatory changes of the superficial cranial arteries. High-resolution MRI is a new observer-independent method that allows visualizing and assessing the superficial cranial arteries in high detail. Extracranial large artery involvement can be evaluated during the same investigation. At present, only single-center experiences with this promising but rather complex procedure exist. A comparative multicenter trial is about to be initiated.
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