CT and MR Imaging of Cardiothoracic Vasculitis

Abstract

The term vasculitis includes a variable group of entities in which the common characteristic is inflammation of the walls of blood vessels occurring at some time during the course of the disease. The vasculitides can be divided into primary and secondary vasculitides, depending on the etiology and according to the size of the vessel affected. Both primary vasculitis and secondary vasculitis are associated with cardiac morbidity that is often subclinical. Cardiac involvement is associated with prognostic implications and higher rates of related mortality. Vasculitis of cardiac structures and the assessment of disease extent are important for appropriate management and selection of treatment. Although echocardiography, radionuclide imaging, and catheter-directed coronary angiography remain the cornerstones of cardiac imaging, cardiac computed tomography and magnetic resonance imaging can offer a 360° assessment of cardiac anatomy, function, and complications secondary to vasculitis. Postoperative complications, which are more frequent in patients with active disease, can also be depicted with those imaging modalities. A multidisciplinary approach is important to yield an appropriate estimate of the disease activity and extent and, therefore, to enable better treatment selection and monitoring. Online supplemental material is available for this article. RSNA, 2018.

Diagnosis and Treatment of Angiography Positive Medium to Large Vessel Childhood Primary Angiitis of Central Nervous System (p-cPACNS): An International Survey

“…Most participants would request MRI angiography (87.3 vs. 88.2%), followed by FLAIR (77.5 vs. 73.5%), diffusion weighted imaging (74.7 vs. 73.5%), T1 FS with contrast application (53.5 vs. 54.4), T2 FS (52.1 vs. 50.0%), T1 FS (42.3 vs. 41.2%), and lastly TIRM or STIR (39.4 vs. 39.7%). Based on published reports, MRI angiography is a strong tool to assess local perfusion and (to some extent) vessel obstruction (18), FLAIR sequences suppress cerebrospinal fluid (CSF) effects which is effective in identifying periventricular hyperintense lesions, such as multiple sclerosis plaques (19). Diffusion weighted imaging helps differentiating between new and old lesions and assess local perfusion in relation to vessel anomalies (20).…”

Vascular abnormalities visualized by multislice computed tomography of the abdomen: accidental findings or immediate causes of pain syndrome? (topic review)

“…КТ-картина представляет равномерное, протяжённое утолщение стенки, в активной острой фазе может присутствовать усиленное контрастирование стенок, стенозы, окклюзии основных ветвей аорты, аневризматическая дилатация аорты или ее ветвей формирование псевдоаневризмы [37,38,39].…”

Imaging of intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data

“…Due to the non-specific clinical and imaging findings, diagnosis of vasculitis is often challenging. This is due to its similarities with other conditions, such as infections, malignancies, connective tissue diseases, and thromboembolic disorders [ 2 – 4 ]. A clinical history of systemic diseases, along with constitutional symptoms, including fever, weight loss, and fatigue, and most importantly, a dramatic response to immunosuppressive therapy could suggest a potential diagnosis of vasculitis.…”