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Takayasu arteritis: intravascular contrast medium for MR angiography in the evaluation of disease activity.

Abstract

OBJECTIVE
Takayasu arteritis is difficult to diagnose, and the evaluation of disease activity is even more challenging. Laboratory, clinical, and radiologic criteria are limited indicators of disease activity. Gadofosveset trisodium is a recently introduced intravascular contrast agent. In this study we sought to investigate a correlation between clinical activity and enhancement of vascular wall thickening in patients with Takayasu arteritis who underwent MR angiography with gadofosveset.
SUBJECTS AND METHODS
Twenty-three consecutively registered patients (21 women, two men) with Takayasu arteritis underwent MR angiography of the supraaortic trunks, aorta, and visceral vessels. Intravascular contrast medium was used to correlate thickened vessel wall enhancement with clinical criteria of disease activity. ECG-triggered black-blood first-pass high-resolution steady-state imaging was performed for all patients.
RESULTS
Before MR angiography, 14 patients were considered to have active disease. Heterogeneous structural involvement of the vascular tree was found. Twenty of 23 patients (87.0%) had supraaortic trunk involvement, including 12 of the 14 patients (85.7%) with active disease. Seventeen of the 23 patients (73.9%) had aortic and visceral vessel involvement, including 12 of the 14 patients (85.7%) with active disease. On steady state images in the active disease group, the mean signal-to-noise-ratio increased from 17.4 to 35.3 after gadofosveset injection (p > 0.0001), while in the nonactive disease group it increased from 52.8 to 69.6 (p = 0.08). A cutoff of 40% was best for differentiating active from inactive disease (sensitivity, 100%; specificity, 89%; positive predictive value, 92%; negative predictive value, 100%).
CONCLUSION
Use of intravascular contrast medium significantly increases the effectiveness of MR angiography in differentiating active and inactive disease.

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  • Publisher Full Text
  • Authors

    Papa M, De Cobelli F, Baldissera E, Dagna L, Schiani E, Sabbadini M, Del Maschio A

    Institution

    Radiology Department, IRCCS San Raffaele Institute, Via Olgettina, 60, 20132, Milan, Italy. papa.maurizio@hsr.it

    Source

    AJR. American journal of roentgenology 198:3 2012 Mar pg W279-84

    MeSH

    Adult
    Aged
    Cardiac-Gated Imaging Techniques
    Contrast Media
    Female
    Gadolinium
    Humans
    Magnetic Resonance Angiography
    Male
    Middle Aged
    Organometallic Compounds
    Predictive Value of Tests
    Sensitivity and Specificity
    Signal-To-Noise Ratio
    Takayasu Arteritis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22358026