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(Circulation. 2000;101:345.)
© 2000 American Heart Association, Inc.
Images in Cardiovascular Medicine |
Takayasu’s Arteritis
Spiral CT Angiography Findings
From the Department of Radiology–Cardiovascular Unit (S.D.Q., J.-F.S., P.R., P.L.), Ambroise Paré Hospital, René Descartes University, Paris V and the Department of Internal Medicine (A.-M.P.), CMC Foch, Suresnes, France.
Correspondence to Salah D. Qanadli, Service de Radiologie, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92104 Boulogne-Billancourt Cedex, France. E-mail salah.qanadli{at}apr.ap-hop-paris.fr
A33-year-old white
woman with Takayasu’s arteritis (nonspecific arteritis) diagnosed 14
years earlier developed subacute dyspnea and hemoptysis. She had
experienced transient cerebral ischemia 3 weeks before
presentation. Spiral CT angiography, performed in a
single breath-hold during a 120-mL bolus injection of 24%
iodinated contrast material, revealed bilateral
stenosis of the pulmonary arteries (Figure 1
), occlusion of the innominate
brachiocephalic trunk with intraluminal thrombus, and stenosis
of the left common carotid artery (Figure 2). Two-dimensional multiplanar
reformations and maximum intensity projection reconstructions were
helpful in evaluating the occlusive lesions. Furthermore, axial images
demonstrated circumferential wall thickening of the aorta and its
branches. No additional invasive imaging procedure was required to
establish the vessel involvement or determine extent of disease. One
month after unsuccessful corticosteroid therapy, the
patient underwent surgical repair of pulmonary
arterial stenoses and an aorta–right subclavian
artery bypass graft. Postoperative spiral CT scan demonstrated no
significant residual stenosis of pulmonary arteries and
allowed graft patency assessment (Figure 3).
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Takayasu’s arteritis is a well-known systemic disease that involves the aorta, major aortic branches, and pulmonary arteries. Catheter angiography has been considered the best method for disease diagnosis, in correlation with clinical data and laboratory findings. However, recent minimally invasive imaging modalities, such as spiral CT and MRI, provide relevant and accurate vascular assessment. Spiral CT angiography has the advantage of combining morphological mural vessel assessment with luminal abnormality evaluation.
Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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