大血管血管炎:多模式成像发现和技术原则
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.).
大血管血管炎 (LVV),包括巨细胞动脉炎 (GCA) 和高山动脉炎 (TA),存在诊断方面的挑战. 多模式的非侵入性成像对于诊断,分类和这些炎症性血管疾病的分期至关重要.
科学领域:
- 血管炎症和自身免疫性疾病.
背景情况:
- 血管性炎症是根据大小分类的炎症性血管疾病.
- 大血管血管炎 (LVV) 包括巨细胞动脉炎 (GCA) 和塔卡亚苏动脉炎 (TA).
- 由于GCA和TA的非特异性症状,诊断具有挑战性.
研究的目的:
- 审查一次性LVV的流行病学,表现,病原和管理.
- 概述LVV的多模式成像发现和技术方面.
- 讨论成像在监测疾病活动和治疗反应中的作用.
主要方法:
- 多模式的非侵入性成像包括超声波 (US),CT血管造影 (CTA),MRI血管造影 (MRA) 和18F-氧糖 (FDG) PET/CT.
- 对GCA和TA成像的国际指南的审查.
- 图像检测结果和技术考虑的描述.
主要成果:
- 建议US作为GCA诊断时动脉活检的第一线替代方案.
- 建议对TA进行横截面身体成像,最好是MRA.
- 功能成像 (FDG PET/CT) 和先进的MRI显示出监测疾病活动和治疗反应的潜力.
结论:
- 非侵入性成像对于诊断,分类和确定LVV病期至关重要.
- 应根据患者表现和当地协议选择成像方式.
- 在监测LVV时,需要对功能和先进的MRI技术进行进一步验证.
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