Bley T A, Ostendorf B, Scherer A, Kellner H, Schmidt W A
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Hamburg - Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Z Rheumatol. 2012 Jul;71(5):430-5. doi: 10.1007/s00393-012-0975-y.
The potentials and pitfalls of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in the diagnosis of large vessel vasculitis are summarized in this review article. With the ability to visualize the lumen and vessel walls of large and medium sized arteries, MRI and MRA have great potential to play a unique role in the diagnosis of large vessel vasculitis. This is underlined by the fact that mural inflammatory changes typically involve uptake of contrast agent that can be visualized with MRI. The cranial, intracranial and extracranial involvement pattern can be studied in a combined approach including an MRI examination of the superficial cranial arteries and an MRA examination of the thoracic aorta with its major supra-aortic branches. Typical MRI sequence parameters are given including monophasic MRA and time-resolved MRA protocols at 3 T. The MRI and MRA techniques have the potential to determine the most suitable (inflamed) segment for temporal artery biopsy and to monitor treatment. Initial results of multicenter studies for the diagnostic accuracy of these relatively new methods are expected soon. The MRA technique is recognized as an interesting alternative to invasive catheter angiography for the evaluation of central nervous system (CNS) vasculitis.
这篇综述文章总结了磁共振成像（MRI）和磁共振血管造影（MRA）在诊断大血管血管炎方面的潜力和缺陷。由于能够可视化大中型动脉的管腔和血管壁，MRI和MRA在大血管血管炎的诊断中具有发挥独特作用的巨大潜力。壁层炎症改变通常涉及造影剂摄取，而这可以通过MRI可视化，这一事实突出了上述潜力。可以采用联合方法研究头颅、颅内和颅外受累模式，包括对浅表颅动脉进行MRI检查以及对胸主动脉及其主要主动脉弓上分支进行MRA检查。文中给出了典型的MRI序列参数，包括3T时的单相MRA和时间分辨MRA方案。MRI和MRA技术有潜力确定颞动脉活检最合适的（发炎）节段并监测治疗情况。预计很快就能得到关于这些相对新方法诊断准确性的多中心研究的初步结果。MRA技术被认为是评估中枢神经系统（CNS）血管炎时侵入性导管血管造影的一种有趣替代方法。
