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[Imaging diagnostics in large vessel vasculitis].

W A Schmidt1, W Hartung2

  • 1Rheumaklinik Berlin-Buch, Immanuel Krankenhaus Berlin, Lindenberger Weg 19, 13125, Berlin, Deutschland. w.schmidt@immanuel.de.

Zeitschrift Fur Rheumatologie
|September 22, 2019
PubMed
Summary
This summary is machine-generated.

Imaging techniques like ultrasound, MRI, and PET can diagnose large vessel vasculitis, including giant-cell arteritis (GCA) and Takayasu arteritis, by showing arterial wall changes. Early imaging before steroid treatment is crucial for accurate diagnosis.

Keywords:
Giant-cell arteritisMagnetic resonance imagingPositron emission tomographyTakayasu arteritisUltrasound

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Area of Science:

  • Vascular Medicine
  • Diagnostic Imaging
  • Rheumatology

Background:

  • Vasculitis, particularly large vessel types like giant-cell arteritis (GCA) and Takayasu arteritis, requires accurate and timely diagnosis.
  • Imaging modalities play a crucial role in identifying arterial wall abnormalities associated with these conditions.

Purpose of the Study:

  • To review the utility of various imaging techniques in the diagnosis of large vessel vasculitis.
  • To highlight the specific imaging findings and optimal timing for these procedures.

Main Methods:

  • Review of imaging findings from ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in large vessel vasculitis.
  • Emphasis on characteristic arterial wall changes depicted by each modality.

Main Results:

  • Ultrasound, MRI, and CT demonstrate homogeneous, concentric arterial wall thickening.
  • FDG-PET detects increased glucose metabolism in the affected arterial wall.
  • Ultrasound is particularly effective for cranial GCA.
  • Imaging findings can normalize rapidly with glucocorticoid treatment.

Conclusions:

  • Imaging can confirm a clinical diagnosis of large vessel vasculitis without histology when performed by specialists.
  • Optimal imaging requires execution before or shortly after initiating glucocorticoid therapy.
  • Initiation of glucocorticoid treatment should not be delayed for planned imaging examinations.