| Imaging for large-vessel vasculitis. | |
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MedLine Citation:
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PMID: 19077714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Ultrasonography, MRI, and PET are increasingly studied in large-vessel vasculitis. They have broadened our knowledge on these disorders and have a place in the diagnostic approach of these patients. RECENT FINDINGS: Temporal artery ultrasonography can be used to guide the surgeon to that artery segment with the clearest 'halo' sign to perform a biopsy, or in experienced hands can even replace biopsy. The distal subclavian, axillary, and brachial arteries can also be examined. High-resolution MRI depicts superficial cranial and extracranial involvement patterns in giant cell arteritis (GCA). Contrast enhancement is prominent in active inflammation and decreases under successful steroid therapy. Presence of aortic complications such as aneurysm or dissection can be ruled out within the same investigation. Large thoracic vessel FDG-uptake is seen in the majority of patients with GCA, especially at the subclavian arteries and the aorta. FDG-PET cannot predict which patients are bound to relapse, and once steroids are started, interpretation is hazardous, which makes its role in follow-up uncertain. Increased thoracic aortic FDG-uptake at diagnosis of GCA may be a bad prognostic factor for later aortic dilatation. In patients with isolated polymyalgia rheumatica - who have less intense vascular FDG uptake - symptoms are caused by inflammation around the shoulders, hips, and spine. SUMMARY: Ultrasonography, MRI, and PET remain promising techniques in the scientific and clinical approach of large-vessel vasculitis. |
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Authors:
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Daniel Blockmans; Thorsten Bley; Wolfgang Schmidt |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in rheumatology Volume: 21 ISSN: 1531-6963 ISO Abbreviation: Curr Opin Rheumatol Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-16 Completed Date: 2009-03-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000851 Medline TA: Curr Opin Rheumatol Country: United States |
Other Details:
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Languages: eng Pagination: 19-28 Citation Subset: IM |
Affiliation:
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General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium. Daniel.Blockmans@uz.kuleuven.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aorta
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pathology,
radionuclide imaging,
ultrasonography Arteries / pathology, radionuclide imaging*, ultrasonography* Fluorodeoxyglucose F18 / diagnostic use Giant Cell Arteritis / pathology, radionuclide imaging, ultrasonography Humans Magnetic Resonance Imaging / methods, trends Positron-Emission Tomography / methods*, trends Predictive Value of Tests Ultrasonography / methods*, trends Vasculitis / pathology, radionuclide imaging*, ultrasonography* |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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