Takayasu arteritis: imaging spectrum at multidetector CT angiography

Zhu, Fengyu; Luo, Shengzheng; Wang, Z J; Jin, Zhengyu; Zhang, L J; Lu, Guang Ming

doi:10.1259/bjr/25536451

Cited by 85 publications

(61 citation statements)

References 25 publications

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“…The main differential diagnosis of IMH is aortitis (eg, Takayasu arteritis or giant cell arteritis), which can also cause uniform thickening of the aortic wall. Aortitis may result in hyperattenuating wall thickening at nonenhanced CT; the wall typically shows enhancement after contrast agent administration and may be associated with transmural calcification (Fig 15) (43,44). In addition, fluorodeoxyglucose (FDG) positron emission tomography (PET) will show diffuse FDG accumulation in areas of active inflammation in the aortic wall in the setting of arteritis and can be used to monitor treatment response (45,46).…”

Section: Differential Diagnosismentioning

confidence: 99%

Emerging Concepts in Intramural Hematoma Imaging

Gutschow¹,

Walker²,

Martínez-Jiménez³

et al. 2016

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Intramural hematoma (IMH) is included in the spectrum of acute aortic syndrome and appears as an area of hyperattenuating crescentic thickening in the aortic wall that is best seen at nonenhanced computed tomography. IMH is historically believed to originate from ruptured vasa vasorum in the aortic media without an intimal tear, but there are reports of small intimomedial tears identified prospectively at imaging or found at surgery in some cases of IMH. These reports have blurred the distinction between aortic dissection and IMH and raise questions about what truly distinguishes the entities that compose acute aortic syndrome. The pathophysiology of these subgroups and the controversies surrounding their differentiation are discussed. The natural history of IMH is highly variable; it may resolve or progress to aneurysm, dissection, or rupture. The authors review various imaging prognostic factors that should be reported by the radiologist, including Stanford classification, maximum aortic diameter, maximum IMH thickness, focal contrast enhancement (including ulcerlike projection and intramural blood pool), and pleural or pericardial effusion. Medical (nonsurgical) versus surgical treatment strategies depend primarily on the Stanford classification, although more recent studies of Asian cohorts report success of initial medical treatment in patients with Stanford type A IMH, with timed (delayed) surgery for patients who develop complications. Understanding the imaging appearance and prognostic factors of IMH helps the radiologist and surgeon identify patients at greatest risk for complications to ensure appropriate treatment and improve patient outcomes. (©)RSNA, 2016.

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Section: Differential Diagnosismentioning

confidence: 99%

Emerging Concepts in Intramural Hematoma Imaging

Gutschow¹,

Walker²,

Martínez-Jiménez³

et al. 2016

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“…Calcification in the thickened wall can also be detected in CT. Multidetector CTA is emerging as a reliable, non-invasive imaging technique to visualize both luminal and mural lesions in the aorta as well as its main branches. 41 The major disadvantage of CT is its enormous radiation exposure, which is hazardous, especially for children with c-TA at the growing age.…”

Section: -Related Diseases Ergotismmentioning

confidence: 99%

Childhood‐onset Takayasu arteritis: an update

et al. 2015

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Childhood-onset Takayasu arteritis (c-TA) is a distinct subset affecting a wide age group, ranging from young infants to adolescents and it differs from adult TA in many aspects. There is scarcity of data on c-TA worldwide. The disease is classified using the European League Against Rheumatism/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society criteria. The non-specific nature of presenting complaints and lack of appropriate biomarkers delay the early diagnosis of this illness and many children present with complications, which become irreversible once they set in. One of the largest cohorts of 40 children with c-TA from our center reports hypertension as the commonest presenting feature. Systemic symptoms like headache, fever and weight loss are also described. Assessment of disease in c-TA is done by correlating clinical features with raised inflammatory markers. Advanced imaging plays an important role in diagnosis. In c-TA, the role of magnetic resonance angiography is advocated, taking into consideration the enormous amount of radiation exposure with other modalities. Complications of c-TA include cardiovascular, pulmonary, neurological and those arising secondary to long-term steroid and immunosuppression therapy.

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“…In patients with symptomatic stenotic or occlusive lesions, interventional or surgical therapy are required. Percutaneous transluminal angioplasty and bypass surgery would be the most common treatment 5. Bypass surgery and reconstruction demonstrated better sustained patency than percutaneous transluminal angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Mid-aortic syndrome secondary to Takayasu’s disease

Cheng

2017

BMJ Case Reports

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A 24-year-old young woman with good past health presented with hypertension during body check. Blood erythrocyte sedimentary rate level was elevated. CT and MR angiography revealed moderate stenosis of abdominal aorta and bilaterally renal arteries. She was diagnosed with mid-aortic syndrome caused by Takayasu arteritis based on clinical, radiological and pathological findings. She was treated with abdominal aorta resection, graft replacement and aorta-renal bypass. Pathology was compatible with Takayasu arteritis. Postoperatively, her blood pressure was normalised. She was prescribed with long-term prednisolone and aspirin for her arteritis.

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Takayasu arteritis: imaging spectrum at multidetector CT angiography

Cited by 85 publications

References 25 publications

Emerging Concepts in Intramural Hematoma Imaging

Emerging Concepts in Intramural Hematoma Imaging

Childhood‐onset Takayasu arteritis: an update

Mid-aortic syndrome secondary to Takayasu’s disease

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