Type:
Educational Exhibit
Keywords:
Vascular, Nuclear medicine
Authors:
Y. Sagara1, H. Kiyosue2, S. Tanoue2, H. Mori1, K. Ishii2; 1Yufu/JP, 2Oita/JP
DOI:
10.1594/ecr2010/C-3156
Background
Vasculitis is relatively rare but can involve all visceral vasculature in whole body, which cause various symptoms depending on the size of the involved vessels and the target organs. Nonspecific symptoms such as fever or general fatigue can be the cause of delay of the correct diagnosis. Intestinal hemorrhage or peritoneal/retroperitoneal hemorrhage occurs with aneurysm formation and ulceration secondary to vasculitis, which can be managed by adequate interventional techniques. Percutaneous balloon angioplasty is one of the effective treatments of renovascular hypertension due to Takayasu’s arteritis. In this article, the authors demonstrate general features of several vasculitis involving abdominal organs, and role of diagnostic and interventional radiology.
Classification
Vasculitis is generally classified into “Large vessel vasculitis”, “Medium-sized vessel vasculitis” and “Small vessel vasculitis” by the size of affected vessels (Table 1) (1). Large vessel vasculitis includes Takayasu arteritis and Giant cell (temporal) arteritis which affects the aorta and its major branches. Medium-sized vessel vasculitis affects the main visceral arteries and their branches including Kawasaki disease and Polyarteritis nodosa. And small-vessel vasculitis affects arterioles, venules, and capillaries. Small vessel vasculitis is divided into immune complex vasculitis such as Henoch-Schönlein purpura and non-immune complex vasculitis. Microscopic polyangiitis, Wegener granulomatosis, and Churg-Strauss syndrome belong to non- immune complex vasculitis and have antineutrophil cytoplasmic autoantibody (ANCA) in common; therefore they are generically called “ANCA–associated small-vessel vasculitis” (2).