Diffusion-Weighted Magnetic Resonance Imaging Detects Vessel Wall Inflammation in Patients With Giant Cell Arteritis

Ironi, Gabriele; Tombetti, Enrico; Napolitano, Angela; Campolongo, Marta; Fallanca, Federico; Incerti, Elena; Picchio, Maria; Dagna, Lorenzo; Manfredi, Angelo A.; Gianolli, Luigi; Maschio, Alessandro Del; Cobelli, Francesco De

doi:10.1016/j.jcmg.2018.06.015

Cited by 23 publications

(6 citation statements)

References 2 publications

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“…Diffusion-weighted MRI of the aorta has also been tested in a pilot study, which showed good agreement between MRI findings, clinical disease activity status and 18 F-FDG PET imaging in patients with GCA. In this study, hyperintense diffusion-weighted MRI signal was observed in all five patients with active or smouldering GCA regardless of wall thickness, but not in three patients with inactive LVV nor in five healthy control subjects 15…”

Section: Imaging Modalitiesmentioning

confidence: 43%

Multimodality imaging of large-vessel vasculitis

Tarkin

Gopalan

2022

Heart

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Multimodality cardiovascular imaging is an essential component of the clinical management of patients with large-vessel vasculitis (LVV), a chronic, relapsing and remitting inflammatory disease of the aorta and its major branches. Imaging is needed to confirm the initial diagnosis, to survey the extent and severity of arterial involvement, to screen for cardiovascular complications and for subsequent long-term disease monitoring. Indeed, diagnosing LVV can be challenging due to the non-specific nature of the presenting symptoms, which often evoke a broad differential. Identification of disease flares and persistent residual arteritis following conventional treatments for LVV present additional clinical challenges. However, by identifying and tracking arterial inflammation and injury, multimodality imaging can help direct the use of disease-modifying treatments that suppress inflammation and prevent or slow disease progression. Each of the non-invasive imaging modalities can provide unique and complementary information, contributing to different aspects of the overall clinical assessment. This article provides a focused review of the many roles of multimodality imaging in LVV.

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Section: Imaging Modalitiesmentioning

confidence: 43%

Multimodality imaging of large-vessel vasculitis

Tarkin

Gopalan

2022

Heart

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“…We postulate that the diffusion restriction noted in the STA branches reflects active vessel wall inflammation, which is supported by the observed resolution of diffusion restriction following steroid therapy. This finding is mirrored by preliminary studies looking at specialized whole-body DWI in extracranial large-vessel GCA [ 7 ], which found mural restricted diffusion in the aorta and axillary arteries of eight patients with GCA, which correlated with disease activity on fluorodeoxyglucose (FDG)-PET/CT. Our series is the first to note STA restricted diffusion on standard conventional DWI head imaging.…”

mentioning

confidence: 73%

DWI scalp dot sign: superficial temporal artery restricted diffusion in giant cell arteritis

et al. 2022

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“…It is currently restricted to specialist centres because, in addition to the dependency to local expertise, MR is more expensive, timeconsuming, highly dependent on technical equipment and might have adverse effects of contrast agents. However, MR technology and availability are evolving, and newer promising applications such as diffusion-weighted sequences have not been widely investigated (141).…”

Section: Discussionmentioning

confidence: 99%

Diagnosing giant cell arteritis: a comprehensive practical guide for the practicing rheumatologist

et al. 2021

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Giant cell arteritis (GCA) is the most common large vessel vasculitis in the elderly population. In recent years, advanced imaging has changed the way GCA can be diagnosed in many locations. The GCA fast-track clinic (FTC) approach combined with ultrasound (US) examination allows prompt treatment and diagnosis with high certainty. FTCs have been shown to improve prognosis while being cost effective. However, all diagnostic modalities are highly operator dependent, and in many locations expertise in advanced imaging may not be available. In this paper, we review the current evidence on GCA diagnostics and propose a simple algorithm for diagnosing GCA for use by rheumatologists not working in specialist centres.

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Diffusion-Weighted Magnetic Resonance Imaging Detects Vessel Wall Inflammation in Patients With Giant Cell Arteritis

Cited by 23 publications

References 2 publications

Multimodality imaging of large-vessel vasculitis

Multimodality imaging of large-vessel vasculitis

DWI scalp dot sign: superficial temporal artery restricted diffusion in giant cell arteritis

Diagnosing giant cell arteritis: a comprehensive practical guide for the practicing rheumatologist

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