Magnetic Resonance Imaging Findings in Temporal Arteritis
We investigated the use of MRI with a gadolinium-based contrast agent (Magnevist, Schering-Plough) for the noninvasive evaluation of temporal arteritis. In contrast-enhanced MRI, arteritis is revealed by increased signal intensity of the inflamed vessel wall. Thickening of an inflamed vessel wall as well as perivascular edema also can be demonstrated and potential aneurysms of the inflamed vessel can be excluded. A dedicated 8-channel phase-array head coil was used on a 1.5-T scanner (Sonata, Siemens Medical Solutions) to produce a stack of high-resolution images with an in-plane resolution of 0.3 mm × 0.2 mm and a slice thickness of 3 mm. Characteristic findings of an inflamed vessel wall in temporal arteritis are shown in Figure 1, in which the image is perpendicular to the vessel orientation. Such contrast-enhanced MRI can provide useful information about the presence, localization, and extent of inflammation of the temporal artery beyond that obtained from clinical and ultrasonographic means. If inflammation is found, then the place of the biopsy can be determined, and potentially the number of false-negative biopsy specimens may be reduced. In addition, treatment with corticosteroids can be monitored as shown in Figures 1 and 2⇓, in which signs of inflammation decreased during therapy.