Current and Emerging Approaches to Imaging Large Vessel Vasculitis.

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Radiology

Background:

• Large vessel vasculitides (LVV) are inflammatory conditions affecting major arteries like the aorta.
• Giant cell arteritis (GCA) and Takayasu arteritis (TA) are primary forms of LVV.
• Untreated LVV can cause severe complications such as blindness, stenosis, and aneurysms.

Purpose of the Study:

• To review the current applications of noninvasive vascular imaging in the diagnosis and management of LVV.
• To highlight the role of imaging in reducing the need for invasive procedures like temporal artery biopsy in GCA.
• To discuss the utility of imaging in monitoring disease activity and treatment response in LVV.

Main Methods:

• Review of current literature on noninvasive vascular imaging techniques in LVV.
• Discussion of imaging modalities including ultrasound, MRI, CT, and PET.
• Analysis of imaging's role in diagnosis, surveillance, and assessment of disease activity.

Main Results:

• Noninvasive imaging has transformed LVV management, enabling prompt diagnosis.
• Imaging techniques like ultrasound, MRI, CT, and PET are routinely used for LVV diagnosis.
• Vascular imaging aids in longitudinal surveillance and is being investigated for assessing treatment response and vascular remodeling.

Conclusions:

• Noninvasive vascular imaging is indispensable in the modern management of large vessel vasculitides.
• Imaging facilitates early detection, reduces reliance on invasive methods, and aids in long-term patient monitoring.
• Ongoing research focuses on imaging's potential to evaluate treatment efficacy and vascular changes in LVV.