Diagnostic Value of High-Resolution MR Imaging in Giant Cell Arteritis

Abstract

BACKGROUND AND PURPOSE:Clinical indications of giant cell arteritis may be unspecific, and noninvasive diagnosis is often difficult. This study investigated the hypothesis that high-resolution MR imaging of the superficial cranial arteries is a noninvasive imaging technique that can detect the occurrence of giant cell arteritis.

3T MRI Reveals Extra- and Intracranial Involvement in Giant Cell Arteritis

“…A sensitivity of 0.80 and a specificity of 0.80 for the detection of GCA by using this imaging protocol were comparable with recent studies with reported values of sensitivities between 0.80% and 0.85% and specificities ranging from 0.71% to 0.95%. 7,17 This result might be accounted for by the differing number of days that patients received corticosteroids before MR imaging examination.…”

“…So far, larger studies focusing on GCA have not reported involvement of any intradural arteries. 7,8,10,11,14 This discrepancy might be caused by the differing study designs and MR imaging protocols that are typically based on the focus of the study. In general, deferring sequence parameters optimized for visualization of mural inflammation of intra-and extracranial vessels are mandatory.…”

“…As previously proposed, mural thickening and prominent contrast enhancement of the vessel wall were considered signs of mural inflammation. 7 MRI signs of extracranial vessel wall inflammation and thickening were documented by each rater separately for all 3 locations bilaterally. In case of differing results, a consensus rating was established.…”

“…6 High-resolution MR imaging studies have been proved to reliably detect mural inflammation such as mural thickening and increased mural contrast enhancement of the superficial temporal and occipital arteries in biopsy-proved GCA. 7,8 Diagnostic criteria for detecting intracranial vasculitis are intramural contrast uptake, in most cases combined with wall thickening. 9 These criteria are valid for patients presenting with primary angiitis of the central nervous system, childhood primary angiitis of the central nervous system or GCA, and other causes of central nervous system vasculitis.…”

Magnetic resonance imaging in the diagnosis and follow-up of giant cell arteritis: case report and review of literature

“…In giant cell vasculitis, inflammation may exclusively involve great blood vessels, which are unavailable to echosonography and biopsy. Therefore, magnetic resonance imaging (MRI) has a major role in the diagnosis of inflammatory lesions in major arterial walls as well as in the follow-up of therapeutic efficacy (2)(3)(4). MRI is also the method of choice in the follow-up of possible complications of inflammatory events in the aortic wall, e.g., aneurysms and dissection (4).…”