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Delayed contrast-enhanced MRI of the coronary artery wall in takayasu arteritis

Christopher Schneeweis1, Bernhard Schnackenburg, Matthias Stuber

  • 1Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.

Plos One
|December 14, 2012
PubMed
Abstract

Insights

Late gadolinium enhancement (LGE) in coronary arteries is common in Takayasu arteritis (TA) patients, similar to those with coronary artery disease (CAD). This LGE finding is unspecific, making it difficult to distinguish between inflammation and fibrosis in TA.

Area of Science:

  • Cardiovascular Imaging
  • Inflammatory Diseases
  • Radiology

Background:

  • Takayasu arteritis (TA) is a rare inflammatory condition affecting the aorta and its branches.
  • Late gadolinium enhancement (LGE) via MRI is valuable for detecting TA-related vessel wall changes.
  • This study compares coronary artery LGE in TA patients versus stable coronary artery disease (CAD) patients.

Purpose of the Study:

  • To assess and compare late gadolinium enhancement (LGE) of the coronary artery wall in patients with Takayasu arteritis (TA) and stable coronary artery disease (CAD).

Main Methods:

  • Nine TA patients and nine CAD patients underwent 3T MRI with a specific gradient-echo sequence.
  • Low-dose gadolinium contrast was administered, with imaging repeated 34-45 minutes post-injection.
  • Coronary vessel wall LGE was evaluated on inversion recovery (IR) scans.

Main Results:

  • No pre-contrast enhancement was observed in either group.
  • Post-contrast LGE was detected in 56% of coronary segments in TA patients and 44% in CAD patients.
  • Quantitative analysis showed no significant difference in coronary artery wall contrast-to-noise ratio (CNR) between TA and CAD groups (p=0.474).

Conclusions:

  • Coronary artery wall LGE is frequently observed in Takayasu arteritis patients, at a similar prevalence and extent as in coronary artery disease patients.
  • The observed coronary LGE in TA appears unspecific.
  • Distinguishing between coronary vessel wall fibrosis and inflammation in TA using LGE remains challenging.

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