García Camacho L, Olea Comas I, Talegón Meléndez A, Castell Monsalve J
Unidad de Gestión Clínica de Radiodiagnóstico, Hospitales Universitarios, Virgen del Rocío, Sevilla, España.
Radiologia. 2009 May-Jun;51(3):287-93. doi: 10.1016/j.rx.2008.10.003. Epub 2009 May 20.
Takayasu arteritis is a chronic inflammatory obliterative disease of the great vessels that mainly affects the aorta and its primary branches. In its early phase, the clinical presentation and laboratory tests are nonspecific, so accurate diagnosis frequently depends on imaging studies. The aim of this study was to review the main features of Takayasu's arteritis and the usefulness of different noninvasive imaging techniques in the early diagnosis and follow-up of this entity.
We included 12 patients diagnosed with Takayasu's arteritis at our center. We retrospectively reviewed the different imaging studies (color Doppler US, multislice CT, and magnetic resonance) employed in each case.
The abdominal aorta and its main branches (renal arteries, superior mesenteric artery, and celiac trunk) were involved in 8 of the 12 patients studied. This involvement was detected as increased velocities in Doppler US that were suggestive of stenosis and was later confirmed on CT angiography and MR angiography. In four patients, CT angiography and MRI angiography demonstrated diffuse and homogeneous vessel wall thickening; in two patients, these techniques also showed enhancement of the thickened walls after contrast administration that suggested active inflammatory disease. Another frequent finding was supra-aortic trunk involvement, which was seen in six cases.
Noninvasive imaging techniques are fundamental in the early diagnosis of patients with Takayasu's arteritis. CT angiography and MR angiography provide additional information about the inflammatory activity of the disease.
高安动脉炎是一种主要累及主动脉及其主要分支的大血管慢性炎症闭塞性疾病。在其早期阶段,临床表现和实验室检查并无特异性,因此准确诊断常常依赖于影像学检查。本研究的目的是回顾高安动脉炎的主要特征以及不同无创成像技术在该疾病早期诊断和随访中的应用价值。
我们纳入了在本中心被诊断为高安动脉炎的12例患者。我们回顾性分析了每例患者所采用的不同影像学检查(彩色多普勒超声、多层螺旋CT和磁共振成像)。
在研究的12例患者中,有8例患者的腹主动脉及其主要分支(肾动脉、肠系膜上动脉和腹腔干)受累。在多普勒超声检查中,这种受累表现为速度增加,提示存在狭窄,随后经CT血管造影和磁共振血管造影得以证实。在4例患者中,CT血管造影和磁共振血管造影显示血管壁弥漫性均匀增厚;在2例患者中,这些检查还显示在注射造影剂后增厚的血管壁出现强化,提示存在活动性炎症疾病。另一个常见的表现是主动脉弓上分支受累,共6例。
无创成像技术在高安动脉炎患者的早期诊断中至关重要。CT血管造影和磁共振血管造影可提供有关该疾病炎症活动的额外信息。