[Imaging procedures in rheumatology: imaging in vasculitis]

Area of Science:

• Rheumatology
• Radiology
• Internal Medicine

Context:

• Vasculitis encompasses a group of diseases characterized by inflammation of blood vessels.
• Accurate diagnosis and monitoring are essential for effective management of vasculitis.

Purpose:

• To review the role of various imaging modalities in the diagnosis and management of small, medium, and large vessel vasculitides.
• To highlight the strengths and limitations of different imaging techniques in detecting vasculitic changes and related complications.

Summary:

• Imaging studies, including magnetic resonance imaging (MRI), computed tomography (CT), and angiography, play a vital role in assessing disease extent, activity, and complications in vasculitis.
• Cranial MRI detects granulomas and inflammation in Wegener's granulomatosis, while CT identifies osseous lesions. Chest radiography and high-resolution CT are used for lower respiratory tract involvement.
• Medium-sized vessel vasculitides like polyarteritis nodosa are associated with aneurysms, often detected via angiography. Large-vessel vasculitides, such as giant cell arteritis and Takayasu arteritis, show characteristic arterial wall thickening on MRI, CT, and duplex sonography.

Impact:

• Provides a comprehensive overview of current imaging practices in vasculitis management.
• Emphasizes the importance of selecting appropriate imaging techniques based on the suspected type and location of vasculitis.
• Highlights recent advancements and correlations with other diagnostic tools like positron emission tomography.