Geiger J, Uhl M, Peter H H, Langer M, Bley T A
Department of Radiology, University of Freiburg, Freiburg, Germany.
Clin Rheumatol. 2008 May;27(5):663-6. doi: 10.1007/s10067-007-0792-x. Epub 2008 Jan 3.
Giant cell arteritis (GCA) is a granulomatous vasculitis. Early diagnosis is important for the initiation of corticosteroid treatment because the arteritis can result in blindness. In most of the cases, the superficial cranial arteries are affected. However, extracranial involvement of various arteries is known. Here, we report a case of histologically proven GCA with an inflammatory stenosis of the right vertebral artery. For complete evaluation of the extension of the disease, an optimized protocol of high-resolution magnetic resonance imaging at 3 T in combination with contrast-enhanced magnetic resonance angiography was performed. This non-invasive method facilitates the differentiation of inflamed and healthy segments of small cranial arteries, may help to find appropriate sites for biopsy, and allows the assessment of affected extracranial vessels. In this patient case, even the cause of vertebral stenosis--inflammatory versus arteriosclerotic--could be elucidated.
巨细胞动脉炎（GCA）是一种肉芽肿性血管炎。早期诊断对于启动皮质类固醇治疗很重要，因为动脉炎可导致失明。在大多数病例中，颅外浅表动脉会受到影响。然而，已知各种动脉可出现颅外受累情况。在此，我们报告一例经组织学证实的GCA病例，该病例存在右椎动脉炎性狭窄。为了全面评估疾病的累及范围，我们采用了3T高分辨率磁共振成像结合对比增强磁共振血管造影的优化方案。这种非侵入性方法有助于区分颅小动脉的炎症段和健康段，可能有助于找到合适的活检部位，并可评估受累的颅外血管。在该患者病例中，甚至可以阐明椎动脉狭窄的原因——炎症性还是动脉粥样硬化性。
