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Gadolinium-enhanced Three-dimensional MR Angiography of Takayasu Arteritis¹

¹ From the Institute of Radiology (M.V.N., R.H.B., R.B., C.C.L., G.G.C.) and Heart Institute (L.P.S.B., L.F.d.A., C.C.d.C.), University of São Paulo Medical School, São Paulo, Brazil. Recipient of an Excellence in Design award at the 2002 RSNA scientific assembly. Received April 7, 2003; revision requested June 8 and received January 28, 2004; accepted February 4. All authors have no financial relationships to disclose. Address correspondence to M.V.N., Rua Itambe 289, ap 507, 01239-001 São Paulo, SP, Brazil (e-mail: marcionastri@yahoo.com).

Takayasu arteritis is a form of large vessel vasculitis with a possible autoimmune origin that may cause stenosis of the aorta and its major branches. Six types of Takayasu arteritis are recognized; the type depends on whether the ascending aorta, descending thoracic aorta, abdominal aorta, aortic cervicobrachial branches, or renal arteries are affected. The coronary and pulmonary arteries are also sometimes involved. Clinical features of the disease include diminished or absent pulses, claudication, hypertension, and mesenteric angina. Conventional angiography has been the standard imaging tool for diagnosis and evaluation of Takayasu arteritis, although it demonstrates only the lumen of the vessel. Less invasive cross-sectional methods such as computed tomographic angiography and, more recently, three-dimensional magnetic resonance (MR) angiography can effectively demonstrate thickening of the vessel wall, which may be the earliest manifestation of the disease, occurring before stenosis and dilatation. MR imaging in particular allows better soft-tissue differentiation and can show other signs of inflammation, including mural edema and increased mural vascularity. Other advantages of MR imaging are the lack of iodinated contrast material or ionizing radiation.

© RSNA, 2004

Index Terms: Aorta, MR, 56.12142, 89.12142, 94.12942, 981.12942 • Aorta, stenosis or obstruction, 56.625, 89.625, 94.625, 981.625 • Aortitis, 56.625, 89.625, 94.625, 981.625 • Takayasu arteritis, 56.625, 89.625, 94.625, 981.625

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