Diagnostic value of contrast-enhanced magnetic resonance angiography in large-vessel vasculitis.

Adler, Sabine; Sprecher, Marco; Wermelinger, Felix; Klink, Thorsten; Bonel, Harald Marcel; Villiger, Peter M (2017). Diagnostic value of contrast-enhanced magnetic resonance angiography in large-vessel vasculitis. Swiss medical weekly, 147, w14397. EMH Schweizerischer Ärzteverlag 10.4414/smw.2017.14397

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OBJECTIVE To evaluate contrast-enhanced magnetic resonance angiography (MRA) in diagnosis of inflammatory aortic involvement in patients with clinical suspicion of large-vessel vasculitis. PATIENTS AND METHODS Seventy-five patients, mean age 62 years (range 16-82 years), 44 female and 31 male, underwent gadolinium-enhanced MRA and were evaluated retrospectively. Thoracic MRA was performed in 32 patients, abdominal MRA in 7 patients and both thoracic and abdominal MRA in 36 patients. Temporal arterial biopsies were obtained from 22/75 patients. MRA positivity was defined as increased aortic wall signal in late gadolinium-enhanced axial turbo inversion recovery magnitude (TIRM) series. The influence of prior glucocorticoid intake on MRA outcome was evaluated. RESULTS MRA was positive in 24/75 patients, with lesions located in the thorax in 7 patients, the abdomen in 5 and in both thorax and abdomen in 12. Probability for positive MRA after glucocorticoid intake for more than 5 days before MRA was reduced by 89.3%. Histology was negative in 3/10 MRA-positive patients and positive in 5/12 MRA-negative patients. All 5/12 histology positive / MRA-negative patients had glucocorticoids for >5 days prior to MRA and were diagnosed as having vasculitis. Positive predictive value for MRA was 92%, negative predictive value was 88%. CONCLUSIONS Contrast-enhanced MRA reliably identifies large vessel vasculitis. Vasculitic signals in MRA are very sensitive to glucocorticoids, suggesting that MRA should be done before glucocorticoid treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Adler, Sabine; Wermelinger, Felix and Bonel, Harald Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

16 Jan 2018 16:00

Last Modified:

21 Jan 2018 02:18

Publisher DOI:

10.4414/smw.2017.14397

PubMed ID:

28322426

BORIS DOI:

10.7892/boris.108387

URI:

https://boris.unibe.ch/id/eprint/108387

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