Double-ring sign in granulocyte colony-stimulating factor-induced vasculitis

Area of Science:

• Vascular Inflammation
• Radiology
• Immunology

Background:

• The double-ring sign on contrast-enhanced computed tomography (CECT) is a recognized imaging finding.
• This sign is traditionally associated with inflammatory changes in Takayasu arteritis, specifically affecting the adventitia and intima.

Purpose of the Study:

• To investigate the occurrence of the double-ring sign in conditions other than Takayasu arteritis.
• To determine if granulocyte colony-stimulating factor (G-CSF)-induced vasculitis exhibits the double-ring sign.

Main Methods:

• Review of contrast-enhanced computed tomography (CECT) findings.
• Analysis of imaging characteristics in patients with Takayasu arteritis.
• Analysis of imaging characteristics in patients with granulocyte colony-stimulating factor-induced vasculitis.

Main Results:

• The double-ring sign was observed in cases of Takayasu arteritis, consistent with prior literature.
• Crucially, the double-ring sign was also identified in patients experiencing granulocyte colony-stimulating factor-induced vasculitis.
• This suggests the double-ring sign is not exclusive to Takayasu arteritis.

Conclusions:

• The double-ring sign, reflecting adventitial and intimal inflammatory changes, is not pathognomonic for Takayasu arteritis.
• Granulocyte colony-stimulating factor-induced vasculitis can present with the double-ring sign on CECT.
• Radiologists should consider a broader differential diagnosis when encountering the double-ring sign.