Diagnostic Approaches for Large Vessel Vasculitides

Albrecht Betrains,1,2 Daniel Blockmans1,2 1Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; 2Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, BelgiumCorrespondence: Danie...

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Autores principales:	Betrains A, Blockmans D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	large vessel vasculitis – giant cell arteritis – takayasu arteritis – periaortitis – pet-scan – ultrasonography – temporal artery biopsy Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/52ec87e6c1b646049299ab085989a109
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spelling	oai:doaj.org-article:52ec87e6c1b646049299ab085989a1092021-12-02T15:50:31ZDiagnostic Approaches for Large Vessel Vasculitides1179-156Xhttps://doaj.org/article/52ec87e6c1b646049299ab085989a1092021-06-01T00:00:00Zhttps://www.dovepress.com/diagnostic-approaches-for-large-vessel-vasculitides-peer-reviewed-fulltext-article-OARRRhttps://doaj.org/toc/1179-156XAlbrecht Betrains,1,2 Daniel Blockmans1,2 1Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; 2Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, BelgiumCorrespondence: Daniel BlockmansDepartment of General Internal Medicine, University Hospitals Leuven, Herestraat 49, Leuven, 3000, BelgiumTel +3216344279Email daniel.blockmans@uzleuven.beAbstract: The large vessel vasculitides comprise giant cell arteritis (GCA), Takayasu arteritis (TAK), and chronic periaortitis. The diagnostic approach to these conditions involves the correct use and interpretation of clinical criteria, imaging techniques, and, in case of GCA, temporal artery biopsy. Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) reveal a homogeneous, concentric, thickening of the arterial wall. MRI and CT may also reveal aneurysms and stenoses. 18F-Fluorodeoxyglucose (FDG)-PET shows increased FDG uptake of inflamed artery walls delineating increased metabolic activity. Ultrasound, FDG-PET, and MRI are the recommended imaging techniques in GCA and TAK. In patients with a high suspicion of GCA who present with visual disturbances, initiation of high-dose intravenous corticosteroids should not be delayed by imaging. Extracranial large vessel vasculitis may be confirmed by all three modalities, particularly by FDG-PET in case of atypical clinical pictures. In this article, we review the role of the GCA and TAK ACR classification criteria, temporal artery biopsy, conventional angiography, ultrasound, MRI, magnetic resonance angiography (MRA), CT angiography (CTA), and FDG-PET in the diagnostic approach of large vessel vasculitis.Keywords: large vessel vasculitis, giant cell arteritis, Takayasu arteritis, periaortitis, PET-scan, ultrasonography, temporal artery biopsyBetrains ABlockmans DDove Medical Pressarticlelarge vessel vasculitis – giant cell arteritis – takayasu arteritis – periaortitis – pet-scan – ultrasonography – temporal artery biopsyDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 13, Pp 153-165 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	large vessel vasculitis – giant cell arteritis – takayasu arteritis – periaortitis – pet-scan – ultrasonography – temporal artery biopsy Diseases of the musculoskeletal system RC925-935
spellingShingle	large vessel vasculitis – giant cell arteritis – takayasu arteritis – periaortitis – pet-scan – ultrasonography – temporal artery biopsy Diseases of the musculoskeletal system RC925-935 Betrains A Blockmans D Diagnostic Approaches for Large Vessel Vasculitides
description	Albrecht Betrains,1,2 Daniel Blockmans1,2 1Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; 2Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, BelgiumCorrespondence: Daniel BlockmansDepartment of General Internal Medicine, University Hospitals Leuven, Herestraat 49, Leuven, 3000, BelgiumTel +3216344279Email daniel.blockmans@uzleuven.beAbstract: The large vessel vasculitides comprise giant cell arteritis (GCA), Takayasu arteritis (TAK), and chronic periaortitis. The diagnostic approach to these conditions involves the correct use and interpretation of clinical criteria, imaging techniques, and, in case of GCA, temporal artery biopsy. Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) reveal a homogeneous, concentric, thickening of the arterial wall. MRI and CT may also reveal aneurysms and stenoses. 18F-Fluorodeoxyglucose (FDG)-PET shows increased FDG uptake of inflamed artery walls delineating increased metabolic activity. Ultrasound, FDG-PET, and MRI are the recommended imaging techniques in GCA and TAK. In patients with a high suspicion of GCA who present with visual disturbances, initiation of high-dose intravenous corticosteroids should not be delayed by imaging. Extracranial large vessel vasculitis may be confirmed by all three modalities, particularly by FDG-PET in case of atypical clinical pictures. In this article, we review the role of the GCA and TAK ACR classification criteria, temporal artery biopsy, conventional angiography, ultrasound, MRI, magnetic resonance angiography (MRA), CT angiography (CTA), and FDG-PET in the diagnostic approach of large vessel vasculitis.Keywords: large vessel vasculitis, giant cell arteritis, Takayasu arteritis, periaortitis, PET-scan, ultrasonography, temporal artery biopsy
format	article
author	Betrains A Blockmans D
author_facet	Betrains A Blockmans D
author_sort	Betrains A
title	Diagnostic Approaches for Large Vessel Vasculitides
title_short	Diagnostic Approaches for Large Vessel Vasculitides
title_full	Diagnostic Approaches for Large Vessel Vasculitides
title_fullStr	Diagnostic Approaches for Large Vessel Vasculitides
title_full_unstemmed	Diagnostic Approaches for Large Vessel Vasculitides
title_sort	diagnostic approaches for large vessel vasculitides
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/52ec87e6c1b646049299ab085989a109
work_keys_str_mv	AT betrainsa diagnosticapproachesforlargevesselvasculitides AT blockmansd diagnosticapproachesforlargevesselvasculitides
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Diagnostic Approaches for Large Vessel Vasculitides

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