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Large Vessel Vasculitis: Multimodality Imaging Findings and Technical Principles.

Mitesh Naik1, Sophie J M Canham1, Luke Dixon1

  • 1From the Department of Radiology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London W6ߙ8RF, UK (M.N., S.J.M.C., L.D., D.G., C.J.H., S.L., S.B., T.D.B.); Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom (D.G.); West London Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, United Kingdom (J.A.P.T., S.M.); Vasculitis Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom (T.Y.); and Department of Surgery and Cancer, Imperial College London, London, United Kingdom (T.D.B.).

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PubMed
Summary
This summary is machine-generated.

Large vessel vasculitis (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TA), presents diagnostic challenges. Multimodality noninvasive imaging is crucial for diagnosis, classification, and staging of these inflammatory blood vessel disorders.

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Area of Science:

  • Vascular inflammation and autoimmune disorders.

Background:

  • Vasculitides are inflammatory blood vessel disorders classified by size.
  • Large vessel vasculitis (LVV) encompasses giant cell arteritis (GCA) and Takayasu arteritis (TA).
  • Diagnosis is challenging due to nonspecific symptoms in GCA and TA.

Purpose of the Study:

  • To review the epidemiology, presentation, pathogenesis, and management of primary LVV.
  • To outline multimodality imaging findings and technical aspects for LVV.
  • To discuss the role of imaging in monitoring disease activity and treatment response.

Main Methods:

  • Multimodality noninvasive imaging including ultrasound (US), CT angiography (CTA), MRI angiography (MRA), and 18F-fluorodeoxyglucose (FDG) PET/CT.
  • Review of international guidance for GCA and TA imaging.
  • Description of imaging findings and technical considerations.

Main Results:

  • US is recommended as a first-line alternative to temporal artery biopsy for GCA diagnosis.
  • Cross-sectional body imaging, preferably MRA, is advised for TA.
  • Functional imaging (FDG PET/CT) and advanced MRI show potential for monitoring disease activity and treatment response.

Conclusions:

  • Noninvasive imaging is essential for diagnosing, classifying, and staging LVV.
  • Imaging modalities should be chosen based on patient presentation and local protocols.
  • Further validation is needed for functional and advanced MRI techniques in monitoring LVV.