Use of imaging studies in the diagnosis of vasculitis

Cardiac magnetic resonance (CMR) has emerged as an important tool for the evaluation of cardiomyopathies, providing highly accurate information on the macroscopic changes of cardiac morphology, function, and tissue composition. For myocardial tissue characterization, the technique of myocardial delayed enhancement is a potentially promising tool for diagnosis, management, and prognosis. Several CMR approaches are now available to better diagnose and prognosticate dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular disease, myocarditis, and other cardiomyopathies.

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“…PAN is a disease characterized by vasculitis of multiple organs [67]. Kidney and heart complications are associated with poor prognosis.…”

Section: Collagen Vascular Diseasesmentioning

confidence: 99%

The emerging role of MRI in the diagnosis and management of cardiomyopathies

Rochitte

Tassi²,

Shiozaki³

2006

Curr Cardiol Rep

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“…However, compared to DSA, they are less sensitive and might result in false-negative results as little changes in smaller order vessels, which is the case in children with PAN, might be missed. With MR angiography, considerable stenotic lesions in small arteries might be overestimated and diagnosed as complete occlusion [27,28].…”

Section: Childhood Polyarteritis Nodosa (C-pan)mentioning

confidence: 99%

Imaging of systemic vasculitis in childhood

et al. 2015

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The term "systemic vasculitis" encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children.

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“…However, there is a 2%-3% complication rate, including contrast nephropathy, peripheral or central venous infection, embolic events, arterial wall dissection, and pseudoaneurysm formation and rupture 5 . CTA was initially studied in Takayasu's arteritis, and more recently polyarteritis nodosa, and was found to aid in the diagnosis with minimal risk of complications [6][7][8][9][10][11] . Since there is significant overlap between Churg-Strauss syndrome and polyarteritis nodosa, it stands to reason that CTA can be of use.…”

Section: To the Editormentioning

confidence: 99%