Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Eur J Radiol. 2011 Feb;77(2):369-74. doi: 10.1016/j.ejrad.2009.08.001. Epub 2009 Aug 31.
To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA).
A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings.
Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only.
MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.
分析多发性大动脉炎(TA)的多排 CT 血管造影(MDCTA)表现谱。
对 15 例临床诊断为大动脉炎的患者进行 MDCTA 检查,回顾性分析其 CT 血管造影表现。将 CTA 表现的发生率与文献中关于大动脉炎的导管血管造影进行比较。9 例患者有实验室参数。如果红细胞沉降率(ESR)升高且 C 反应蛋白(CRP)阳性,则认为疾病处于活动期。试图将疾病活动与影像学表现相关联。
15 例患者中有 14 例(93%)累及升主动脉、主动脉弓和降胸主动脉。壁厚度在 1-10mm 之间,以弓和降胸主动脉最明显。11 例(73%)患者的主要颈部血管受累,其中最明显的变化见于头臂干、左颈总动脉(CCA)和左锁骨下动脉(SCA)。11 例(100%)进行腹部 CT 检查的患者均累及腹主动脉及其分支。10 例(91%)患者的腹腔干和 SMA 受累,7 例(64%)患者分别受累,5 例(45%)患者存在肾动脉狭窄。6 例患者的 ESR 升高且 CRP 阳性,提示疾病活动。所有可获得实验室参数的患者均显示主动脉和至少一个颈部血管的壁增厚,除了一例处于非活动期的患者仅有主动脉壁增厚。
MDCTA 可提供大动脉炎患者的血管壁和管腔信息。