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      Insights into imaging of aortitis

      review-article
      1 , 3 , , 2 , 1
      Insights into Imaging
      Springer-Verlag
      Aortitis, Vasculitis, MDCT, MR, PET-CT

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          Abstract

          Background

          Aortitis is a subtype of the more general term “vasculitis”, an inflammatory condition of infectious or noninfectious origin involving the vessel wall. The term “vasculitis” refers to a broad spectrum of diseases with different aetiologies, pathophysiologies, clinical presentations and prognoses. The clinical manifestations are nonspecific, as are the laboratory findings such as pain, fever, weight loss, vascular insufficiency and elevated levels of acute phase reactants, as well as other systemic manifestations, and sometimes may mimic other entities. Thus, if not suspected as part of the initial differential diagnosis, aortitis can be overlooked during the workup of patients with constitutional symptoms and systemic disorders. Methods: Imaging is rarely used for the primary diagnosis, but imaging findings, although nonspecific, can help in the assessment of these patients and is often required for making the final diagnosis. Imaging can be critical in the initiation of appropriate management and therapy. Results: Noninvasive cross-sectional imaging modalities such as contrast-enhanced CT, magnetic resonance (MR) imaging, nuclear medicine and in particular positron emission tomography (PET) are the leading modalities in modern diagnostic imaging of aortitis for both the initial diagnosis and follow-up. Conclusion: This review focusses on the most common manifestations of aortitis with which radiologists should be familiar.

          Teaching Points

          Aortitis is an inflammatory condition of infectious/noninfectious origin involving the vessel wall .

          Imaging findings can help in the assessment of aortitis and are often crucial for the final diagnosis .

          Contrast-enhanced CT, MRI and PET-CT are used for both the initial diagnosis and follow-up of aortitis .

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          Most cited references83

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          2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine.

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            Behçet's disease.

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              The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis.

              Criteria for the classification of Takayasu arteritis were developed by comparing 63 patients who had this disease with 744 control patients with other forms of vasculitis. Six criteria were selected for the traditional format classification: onset at age less than or equal to 40 years, claudication of an extremity, decreased brachial artery pulse, greater than 10 mm Hg difference in systolic blood pressure between arms, a bruit over the subclavian arteries or the aorta, and arteriographic evidence of narrowing or occlusion of the entire aorta, its primary branches, or large arteries in the proximal upper or lower extremities. The presence of 3 or more of these 6 criteria demonstrated a sensitivity of 90.5% and a specificity of 97.8%. A classification tree also was constructed with 5 of these 6 criteria, omitting claudication of an extremity. The classification tree demonstrated a sensitivity of 92.1% and a specificity of 97.0%.
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                Author and article information

                Contributors
                +1-617-6679556 , +1-617-6670665 , dlitmano@bidmc.harvard.edu
                Journal
                Insights Imaging
                Insights Imaging
                Insights into Imaging
                Springer-Verlag (Berlin/Heidelberg )
                1869-4101
                20 September 2012
                20 September 2012
                December 2012
                : 3
                : 6
                : 545-560
                Affiliations
                [1 ]Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
                [2 ]Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey
                [3 ]Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 USA
                Article
                192
                10.1007/s13244-012-0192-x
                3505571
                22991323
                e2e820e1-6a77-44f8-9dd4-5eecea6312ba
                © The Author(s) 2012
                History
                : 20 May 2012
                : 8 August 2012
                : 9 August 2012
                Categories
                Review
                Custom metadata
                © The Author(s) 2012

                Radiology & Imaging
                aortitis,pet-ct,vasculitis,mr,mdct
                Radiology & Imaging
                aortitis, pet-ct, vasculitis, mr, mdct

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