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Imaging of Small Artery Vasculitis.
Omar Hamam1, Samuel C Cartmell1, Javier M Romero1
1Neurovascular Laboratory R.H Ackerman, Radiology, Mass General Brigham, 55 Fruit street, Boston, MA, 02115, USA.
Neuroimaging Clinics of North America
|November 11, 2023
Summary
Central nervous system small artery vasculitis involves brain and spinal cord blood vessel inflammation. Diagnosis is challenging, with imaging crucial for identifying immune complex deposition or anti-neutrophil cytoplasmic antibody (ANCA)-associated conditions.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Small artery vasculitis of the central nervous system (CNS) is a rare but severe condition.
- It involves inflammation of blood vessels in the brain and spinal cord.
- Accurate diagnosis is often challenging.
Purpose of the Study:
- To outline the classification of small artery vasculitis of the CNS.
- To highlight the diagnostic role of imaging in these conditions.
Main Methods:
- Classification based on immunoglobulin complex deposition in vessel walls.
- Categorization into immune complex-mediated and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis.
- Emphasis on the role of diagnostic imaging.
Main Results:
- Two main groups of small artery vasculitis of the CNS identified: immune complex deposition present and absent.
- Immune complex-mediated vasculitis includes anti-glomerular basement membrane disease, cryoglobulinemic vasculitis, and IgA vasculitis.
- ANCA-associated vasculitis includes microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and primary angiitis of the CNS.
Conclusions:
- Understanding the classification of CNS small artery vasculitis is key for diagnosis.
- Imaging techniques are essential tools in diagnosing these challenging conditions.
- Distinguishing between immune complex deposition and ANCA-associated vasculitis aids in patient management.
