Oura Kazumasa, Yamaguchi Oura Mao, Itabashi Ryo, Maeda Tetsuya
Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba-Cho, Shiwa-Gun, Morioka 028-3695, Japan.
Diagnostics (Basel). 2021 Oct 27;11(11):1993. doi: 10.3390/diagnostics11111993.
Takayasu arteritis (TA) is a large vessel vasculitis that causes stenosis, occlusion, and sometimes the aneurysm of the aorta and its major branches. TA often occurs in young women, and because the symptoms are not obvious in the early stages of the disease, diagnosis is difficult and often delayed. In approximately 10% to 20% of patients, TA is reportedly complicated by ischemic stroke or transient ischemic attack. It is important to diagnose TA early and provide appropriate treatment to prevent complications from stroke. Diagnostic imaging techniques to visualize arterial stenosis are widely used in clinical practice. Even if no signs of cerebrovascular events are present at the time of the most recent evaluation of patients with TA, follow-up vascular imaging is important to monitor disease progression and changes in the cerebrovascular risk. However, the optimal imaging technique for monitoring of TA has not been established. Therefore, the purpose of this review is to describe newly available evidence on the usefulness of conventional imaging modalities (digital subtraction angiography, computed tomography angiography, magnetic resonance imaging/angiography, duplex ultrasound, and positron emission tomography) and novel imaging modalities (optical coherence tomography, infrared thermography, contrast-enhanced ultrasonography, and superb microvascular imaging) in the diagnosis and monitoring of TA.
高安动脉炎(TA)是一种大血管血管炎,可导致主动脉及其主要分支狭窄、闭塞,有时还会形成动脉瘤。TA常发生于年轻女性,由于疾病早期症状不明显,诊断困难且往往延迟。据报道,约10%至20%的患者会并发缺血性中风或短暂性脑缺血发作。早期诊断TA并提供适当治疗以预防中风并发症非常重要。用于可视化动脉狭窄的诊断成像技术在临床实践中广泛应用。即使在对TA患者进行最新评估时没有脑血管事件的迹象,后续的血管成像对于监测疾病进展和脑血管风险变化也很重要。然而,尚未确定用于监测TA的最佳成像技术。因此,本综述的目的是描述传统成像方式(数字减影血管造影、计算机断层扫描血管造影、磁共振成像/血管造影、双功超声和正电子发射断层扫描)和新型成像方式(光学相干断层扫描、红外热成像、对比增强超声和超微血管成像)在TA诊断和监测中的新可用证据。