Magnetic Resonance Angiography and Multidetector CT Angiography in the Diagnosis of Takayasu's Arteritis: Assessment of Disease Extent and Correlation with Disease Activity

Abstract

Background: Takayasu’s arteritis (TA) is a large vessel vasculitis with diverse clinical presentations and arterial vascular bed involvement. It is characterized by chronic, nonspecific inflammation of all layers of the vessel wall, which results in stenosis, occlusion, dilatation, or aneurysm formation in the involved blood vessels. Methods: The study included 36 patients of TA. All patients fulfilled the modified Ishikawa’s diagnostic criteria for TA. All patients were evaluated for clinical presentation, angiographic findings, and severity of the disease. The disease activity was assessed based on Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and also by CT angiography (CTA)/Magnetic resonance angiography (MRA) imaging. The angiographic types were classified based on the International TA Conference in Tokyo, 1994 angiographic classification. Results: total of 36 patients were included in the study, 86% were females and a mean age of 21.6 years. Hypertension (78%) was the most common clinical presentation. Type V was the most common angiographic type (42%), followed by type III (25%), type IV (14%), type IIb (11%), type I (5%) and type IIa (3%). Among the aortic arch branches, the left subclavian artery (50%), right subclavian artery (38.8%), left vertebral artery (33.3%) and left common carotid artery (27.7%) were the most commonly involved arteries. Disease activity based on CT/MR imaging showed a significant statistical correlation with elevated ESR and positive CRP (p < 0.0001). Mediastinal lymphadenopathy was seen in 21 patients, out of which 11 had active disease. However, no significant correlation was found between mediastinal lymphadenopathy and disease activity. Conclusions: TA presents varied symptomatology and differing vascular involvement. CT/MR angiography is effective in diagnosis and accurately predicted the active stage of the disease.

Tuberculosis and Takayasu arteritis: a case report

“…TAK diagnosis was suspected regarding clinical findings such as fever and hypertension, which are the most reported in literature[ 11 ] and confirmed by radiological features since CT angiography is among the gold standard of radiological exploration [ 12 ]. Our patient fulfilled criteria of TAK according to the most scientific societies [European League Against Rheumatism (EULAR)/Paediatric Rheumatology International Trials Organisation (PRINTO)/Paediatric Rheumatology European Society (PRES) for pediatric patients, and American College of Rheumatology] [ 13 , 14 ].…”

Accelerated Two‐Point Dixon MR Angiography Improves Diagnostic Performance for Cervical Artery Diseases

“…Although MIP visualization of cMRA would be enhanced with postprocessing to eliminate subcutaneous fat signals, this usually requires time‐consuming manual processing 30 . The improved visualization of the small collateral arteries with FLEXA may also be useful in evaluating the status and treatment response of steno‐occlusive diseases like moyamoya disease 31 and Takayasu's arteritis 32 . Face arterial anatomy is known for its extreme variation 33 .…”

“…30 The improved visualization of the small collateral arteries with FLEXA may also be useful in evaluating the status and treatment response of steno-occlusive diseases like moyamoya disease 31 and Takayasu's arteritis. 32 Face arterial anatomy is known for its extreme variation. 33 Therefore, improving preoperative comprehension of the arterial branches in patients undergoing intravascular or open surgery would potentially reduce the risk of unexpected embolization 34 or dissection of vessels.…”

The evaluation value of intracranial magnetic resonance angiography combined with carotid ultrasound in cerebral infarction

“…Intracranial magnetic resonance angiography (MRA) is a non-invasive imaging method commonly used in the diagnosis and evaluation of CI. 6 MRA has excellent correlation with cerebral angiography and can accurately show the number of diseased blood vessels, degree of stenosis, and specific location, as well as precisely reflect the degree of intracranial arteriosclerosis. 7 Another method, carotid ultrasound (CU) is also an important non-invasive diagnostic technique for CI because of its simplicity and reproducibility, and is routinely used as a risk stratification tool for cerebral and cardiovascular events.…”