Lutter Georg, Puehler Thomas, Röcken Christoph, Both Marcus
Department of Cardiac and Vascular Surgery, University Medical Center Schleswig Holstein, Campus Kiel, Kiel, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Hamburg/ Kiel/ Lübeck, Kiel, Germany.
Eur Heart J Case Rep. 2022 Apr 12;6(4):ytac152. doi: 10.1093/ehjcr/ytac152. eCollection 2022 Apr.
Inflammatory manifestation in the aortic arch can be a complication of giant cell arteritis (GCA), potentially requiring surgical therapy in the case of aneurysmatic dilatation.
We report the case of a 73-year-old female patient with GCA in whom a typical appearance of arteritis was visualized on magnetic resonance imaging of the superficial temporal arteries. Additionally, ectasia (4.7 cm) of the ascending aorta with a mural rim of increased contrast media uptake was detected at the time of the initial diagnosis, which is an indicator of aortitis. While the diameter had only minimally increased in a computed tomography angiography (CTA) examination after 8 months, a subsequent CTA revealed an increased diameter of 5.8 cm and maximum at the level of the ascending aorta another 22 months later, indicating urgent surgery to replace the ascending aorta.
Magnetic resonance imaging can detect silent, generalized manifestations of GCA such as severe aortitis, which may possibly lead to aneurysmatic dilatation, urging closer follow-up imaging. Detection of the ongoing process and subsequent follow-up imaging protects patients by avoiding rupture.
主动脉弓的炎症表现可能是巨细胞动脉炎（GCA）的一种并发症，在动脉瘤样扩张的情况下可能需要手术治疗。
我们报告了一例73岁患有GCA的女性患者，其颞浅动脉磁共振成像显示出典型的动脉炎表现。此外，在初次诊断时检测到升主动脉扩张（4.7厘米），伴有造影剂摄取增加的壁缘，这是主动脉炎的一个指标。虽然8个月后的计算机断层血管造影（CTA）检查显示直径仅略有增加，但随后的CTA显示22个月后升主动脉直径增加到5.8厘米且在升主动脉水平达到最大值，这表明需要紧急手术置换升主动脉。
磁共振成像可以检测到GCA的无症状、全身性表现，如严重的主动脉炎，这可能会导致动脉瘤样扩张，因此需要更密切的随访成像。对疾病进展过程的检测以及随后的随访成像可避免破裂，从而保护患者。
